Range of Motion Testing - (CPG146)

Cigna covers formal ROM testing (CPT 95851-95852) only when multiple extremities or trunk musculature are affected and additional testing beyond standard E/M or therapy evaluations is needed to develop the plan of care (e.g., spinal cord injury, TBI, MS, stroke, Parkinson’s, cerebral palsy) and excludes routine, incidental, single-joint, baseline measurements included in initial E/M/therapy evaluations or tests for non-covered diagnoses. These codes require the practitioner's interpretation with a separate dated/signed report, testing of every joint/muscle in the affected extremity or trunk per the code descriptor with documented rationale and relevance to the plan of care, and are not appropriate for routine/periodic use or justified solely by digital device reports.

"Range of Motion (ROM) Testing is considered medically necessary for medical conditions that impact multiple extremities and trunk musculature when further testing or evaluation beyond what is inclu..."