External Counterpulsation - (0058)

Cigna covers up to 35 ECP sessions (HCPCS G0166) for adults with chronic stable angina (CCS class III–IV or equivalent) only when pharmacologic therapy has failed/is contraindicated/intolerant AND there is documented ischemia on an imaging stress test plus obstructive CAD not amenable to PCI or CABG. ECP is not medically necessary for all other indications (e.g., CHF, arrhythmia, erectile dysfunction, long COVID, microvascular angina, severe HTN, stroke, unstable angina, peripheral vascular disease, etc.), and treatment must avoid manufacturer contraindications/precautions (e.g., active DVT, significant aortic insufficiency/AAA, anticoagulation problems, uncontrolled arrhythmia/HTN, recent surgery); required documentation includes CCS class, failed pharmacotherapy, ischemia on imaging, and non‑revascularizable CAD.

"A course of up to 35 sessions of external counterpulsation (ECP) is considered medically necessary for the treatment of chronic stable angina pectoris as defined by the Canadian Cardiovascular Soci..."