Head and Neck Ultrasound - (0549)

Cigna covers head and neck soft-tissue ultrasound (CPT 76536) only for specified indications—neoplasm/mass or suspicious lymph node, thyroid/parathyroid disease including high‑risk thyroid screening, thyrotoxicosis, thyroid nodule/multinodular goiter, congenital primary hypothyroidism, primary hyperparathyroidism/hypercalcemia, salivary gland disease/stones/infection, suspected/known foreign body, or to assess infection/abscess—and excludes transcranial Doppler, carotid duplex, ultrasound for biopsy guidance, and any other unlisted indications. Reimbursement requires clinical documentation and a covered ICD‑10 diagnosis from the policy with appropriate coding (use CPT 76536); claims without a listed diagnosis or supporting documentation will be denied, and routine population thyroid screening is not covered.

"Ultrasound of head and neck soft tissues is considered medically necessary for an individual with ANY of the following indications:"