P2P Call Guide

How to Win a P2P Call for Colonoscopy Denied by Cigna

Payer-specific strategy, medical necessity arguments, and the exact phrases to use when Cigna / Evernorth denies Colonoscopy (CPT 45378, 45380, 45385).

Why Cigna Denies Colonoscopy

Screening interval not met

Prior authorization not obtained

Age does not meet screening criteria

Know Cigna / Evernorth's Criteria

Cigna uses their own Coverage Policies and InterQual criteria. Medical directors are generally accessible for P2P review.

Key policies to know:

  • Coverage Policies available on cigna.com/coverage-policies
  • Uses eviCore for specialty benefits management
  • Known for step therapy requirements on specialty drugs
  • Collaborative care approach with emphasis on outcomes data

Building Your Medical Necessity Argument

Distinguish diagnostic from screening indication

Document symptoms warranting diagnostic colonoscopy

Reference family history or personal risk factors

Note positive screening test (FIT, Cologuard) requiring follow-up

P2P Call Tips for Cigna

Reference Cigna Coverage Policy by number

Cigna medical directors tend to be collaborative -- frame it as shared decision-making

Emphasize outcomes data and evidence-based medicine

Be prepared to discuss alternatives and why they were insufficient

Guidelines to Reference

  • USPSTF Colorectal Cancer Screening Recommendations
  • AGA Guidelines for Colonoscopy Surveillance
  • NCCN High-Risk Screening Guidelines

Relevant CPT Codes

CPT 45378CPT 45380CPT 45385

Specialty: Gastroenterology

Want the full strategy?

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