Molecular Laboratory Testing Program
Cigna HealthcareSM delegates precertification to EviCore by Evernorth® for certain Current Procedural Terminology (CPT®) codes for molecular laboratory testing. This program went into effect on November 1, 2024.
The program ensures customers receive coverage for the appropriate use of molecular (genetic) testing through evidence-based clinical policies, medical necessity review, and claims payment rules.
There are more than 70,000 available genetic tests, with new tests added quarterly. EviCore’s precertification process reviews requests to ensure there is sufficient clinical evidence to support the use of the test that is requested.
Current Procedural Terminology codes
A full list of Current Procedural Terminology (CPT®) codes associated with the affected tests, as well as additional information, is available at Cigna Provider Resources | EviCore by Evernorth > Solution Resources > Laboratory Management > Cigna Laboratory Management Code List
Precertification requests
Request precertification through these channels:
- Portal: EviCore.com
The EviCore portal is the quickest and most efficient way to request prior authorization 24/7. - Telephone: 866.668.9250
The EviCore call center is open from 7:00 a.m. to 7:00 p.m. local time.
It is the responsibility of the provider to obtain precertification. Precertification requests must include the following information:
- Patient’s name, date of birth, and ID number from their Cigna Healthcare ID card
- Ordering provider’s name, National Provider Identifier (NPI), Taxpayer Identification Number (TIN), and address
- Rendering facility’s name, NPI, TIN, and address
- Supporting clinical information
Additional Information
- Medical coverage guidelines: EviCore Cigna Commercial Membership | EviCore by Evernorth
- Resources: Cigna Provider Resources | EviCore by Evernorth > Solution Resources > Laboratory Management
- Clinical support: EviCore welcomes requests for clinical discussions.
- Telephone: 866.668.9250
- Portal: Provider's Hub | EviCore by Evernorth