We’re making updates to help you identify and resolve certain electronic claim submission errors more quickly
AI Summary
Cigna Healthcare is implementing real-time claim rejection for EDI submissions with unacceptable primary diagnosis codes starting July 1, 2026. Claims with invalid primary diagnoses will be rejected at submission (not after processing) and returned with specific error codes A7 and 255 for immediate correction.
Action Required
By July 1, 2026: Billing team must update practice management systems to recognize and handle 277CA rejection responses with codes A7 and 255. Train staff on ICD-10-CM guidelines to identify unacceptable primary diagnosis codes (manifestations, external causes, sequelae, 'code first' conditions) before submission. Review Policy R38 on CignaforHCP.com and contact clearinghouse to ensure systems are ready for point-of-submission rejections.
Plan Types
Commercial
Specialties
all-specialties