Scrotal Ultrasound - (0548)

Cigna covers scrotal ultrasound (CPT 76870) only for the policy’s specific indications (e.g., acute scrotal pain/torsion, trauma, infection/inflammation, scrotal mass/neoplasm, family history of testicular cancer, varicocele, hydrocele/spermatocele, suspected occult inguinal hernia, nonpalpable testes ≥6 months, infertility evaluation, follow‑up of indeterminate US, and testicular evaluation in malignancy) and excludes all other uses (it does not cover penile vessel ultrasound or ultrasound for biopsy guidance). Claims must include an applicable covered ICD‑10‑CM code from the policy and clinical documentation supporting one of the listed indications (thorough H&P with standing/supine findings when relevant, age documentation for nonpalpable testes, inability to confirm occult hernia on exam, prior imaging/treatment details when applicable); claims without a covered diagnosis code will be denied.

"Acute scrotal pain or testicular torsion"