Laboratory Testing Services - (0604)

Cigna covers laboratory tests only when they are scientifically and clinically valid (supported by peer‑reviewed evidence), FDA‑cleared/approved or performed in CLIA‑certified labs, ordered by a qualified clinician actively managing care, consistent with the manufacturer’s indications and USPSTF A/B or professional society guidance, not duplicative, and expected to directly impact patient management; tests are not covered for general population screening without signs/symptoms, when performed outside intended use, as duplicative or without documented clinical change, and a list of specific CPT codes and proprietary assays (e.g., PreTRM, Immunoscore, Promarker D, NaviDKD) are classified as not medically necessary or experimental/investigational. Required documentation includes evidence of analytical/clinical validity, FDA/CLIA status, clinical indication and how results will change management, appropriate coding, and justification for panel testing or repeat testing/retesting intervals.