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- Cigna to Keep Paying the Professional Component of Clinical Pathology Services after CAP Expresses Concerns
In response to the CAP’s engagement, Cigna informed the CAP on June 7 that the decision is imminent. The CAP learned health insurance payer Cigna plans to continue reimbursing pathologists for the professional component of clinical pathology services. A formal update regarding the policy to pay for the professional component of clinical pathology would be forthcoming soon.
The CAP had strongly urged the health insurer Cigna to rescind its policy to deny claims when the professional component (modifier 26) of clinical pathology is billed. In a CAP letter to Cigna on April 23, the CAP urged the insurer to continue paying for the professional component of clinical pathology services for all pathologists. The CAP further engaged with the presidents of state pathology societies and state issue advisors on the Cigna policy and gathered feedback on how the change will affect pathologists in their states. Several state pathology societies also sent letters to Cigna urging them to reverse course.
Cigna had announced the payment policy change on April 12 and said the denials would take effect in July. The change would have affected pathologists in several states. In communications to Cigna, the CAP maintained the professional component of clinical pathology (PC of CP) services are critical to the reliable and accurate diagnosis and treatment of patients. For Cigna to discontinue reimbursement for these services will prove detrimental to patients, and to the integrated delivery of care to which laboratory diagnostic services are central. More updates on this new development will be published in future editions of Advocacy Update and on our Advocacy Twitter channel.