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- CAP Opposes Cigna’s Plan to Deny Pay for Professional Component of Clinical Pathology
The CAP opposes a new payment policy announced by Cigna on April 12 to deny claims when the professional component (modifier 26) of clinical pathology is billed. The denials will take effect July 11. The CAP will engage with Cigna and ask for a meeting to further discuss the policy.
The change would affect pathologists in many states as CAP has been alerted to this issue by pathologists in Pennsylvania and California. Cigna also offers individual and family health insurance plans in Arizona, Colorado, Florida, Illinois, Kansas, Missouri, North Carolina, Tennessee, Utah, and Virginia.
The CAP maintains the professional component of clinical pathology 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 the integrated delivery of care to which laboratory diagnostic services are central.
The CAP will keep its members informed on this issue as new developments are available. Go to our private sector advocacy webpage for more information.