Cardiac Ablation of Abnormal Electrical Rhythms in Adults - (0529)

Cigna covers transcatheter catheter ablation in adults (≥18) for specified supraventricular arrhythmias (e.g., accessory‑pathway/AVRT including preexcited AF/high‑risk EP findings, CTI‑dependent atrial flutter including when induced during AF ablation, recurrent non‑CTI flutter, AVNRT, focal AT) and for ventricular arrhythmias (junctional tachycardia when medical therapy fails/is contraindicated, PVCs with >15% burden or symptomatic and refractory/contraindicated/intolerant/not preferred to meds, and VT/VF refractory/intolerant to medical therapy), while ablation for inappropriate sinus tachycardia and premature atrial contractions is not medically necessary and cardio‑neuroablation, thoracoscopic epicardial ablation and hybrid convergent approaches are considered experimental/investigational. Coverage requires age ≥18, supporting ECG/EP documentation confirming arrhythmia mechanism and localization (including PVC burden when applicable), documentation that medical/pharmacologic therapy was ineffective/contraindicated/not tolerated or not preferred when required, and correct CPT/diagnosis coding and procedural documentation.