Injectable Fillers for Head and Neck Conditions - (0511)

Cigna covers laryngeal injection with FDA‑approved bulking agents (e.g., calcium hydroxylapatite, autologous fat) for unilateral vocal cord paralysis, autologous fat injection for velopharyngeal insufficiency only when all four criteria are met (history of hypernasal speech, nasal regurgitation, naso‑endoscopic evidence of functional VPI, and SLP evaluation showing impairment not correctable by therapy), and FDA‑approved fillers (e.g., Sculptra, Radiesse) for photographically documented HIV‑associated facial lipodystrophy; all other injectable filler uses (including cosmetic indications and off‑label/unproven uses such as Restylane/Juvederm, hyaluronic acid or PLLA for vocal cords) are not medically necessary. Required documentation includes clinical findings/supporting diagnosis, naso‑endoscopy, pre/post procedure voice and vocal fold exams, SLP evaluation or photographic proof as applicable, device/product and amount injected, and appropriate CPT/HCPCS coding or claims will be denied.