Transthoracic Echocardiography in Adults - (0510)

Cigna covers non‑stress transthoracic echocardiography (TTE) in adults only for indications consistent with ACC AUC/ACC‑AHA guidelines as listed in the policy, excludes routine pre‑ADHD‑medication screening and any indications not enumerated, and generally limits routine reimbursement to two TTEs per rolling 12 months (with specified Table 2 exceptions). Claims must be billed with a Table 1 covered ICD‑10‑CM diagnosis (additional TTEs require a Table 2 diagnosis to justify >2/year), myocardial strain imaging (CPT 93356) is covered only when performed with a medically necessary primary TTE for cardiotoxicity monitoring or hypertrophic cardiomyopathy, and services not meeting these criteria will be denied.

"Non-stress transthoracic echocardiography (TTE) in adults (age 18 and older) considered medically necessary when consistent with ACC Appropriate Use Criteria (AUC) 'Appropriate Care' category (scor..."