Spinal Ultrasound - (CPG038)

Cigna covers spinal/paraspinal ultrasound only for intraoperative use and for specified neonatal/infant (<2 years) indications (e.g., evaluation of spinal dysraphism, suspected spinal tumors/vascular malformations, caudal regression, LP guidance, postoperative cord retethering, and visualization of spinal blood products) and deems diagnostic spinal ultrasound for adult nonoperative evaluations (e.g., discs, facet joints, radiculopathy, back pain, rehab) and any other unlisted indications not medically necessary. Reimbursement requires documentation of the covered indication (including age <2 or intraoperative use), use of the specified diagnosis/procedure codes per the policy (claims without covered codes will be denied), adherence to listed contraindications, and MRI follow-up is recommended if neonatal/infant ultrasound is abnormal, equivocal, or technically limited.

"Spinal and/or paraspinal ultrasound is considered medically necessary in newborns and infants (i."