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Breast cancer does not pause for pregnancy and postpartum
Act
immediately
Effective date
Not stated in the notice
Identified
Sep 29, 2026
Summary
Cigna Healthcare has expanded coverage for breast cancer screening services to include MRIs, ultrasounds, biopsies, and pathology procedures at no cost when needed to complete screening or address initial findings. This policy emphasizes continued screening during pregnancy and postpartum periods and references the updated Preventive Care Services (A004) administrative policy for specific CPT codes.
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What to do
immediately · 5 steps
01Billing team must update billing systems and encounter forms to reflect zero cost-sharing (no out-of-pocket costs) for breast imaging (MRI, ultrasound), biopsies, and pathology procedures when used for breast cancer screening.
02Reference the Preventive Care Services (A004) administrative policy for complete Current Procedural Terminology (CPT) code list—this policy document does not specify individual codes.
03Verify coverage eligibility based on patient's Cigna Healthcare benefit plan and ensure screening age requirements are met (age 40+ for average risk; earlier for elevated risk).
04Train front desk and billing staff that patients should not be billed cost-sharing for these services when ordered as preventive care screening.
05Update patient education materials to communicate zero out-of-pocket costs to increase adherence.
If missed: Failure to remove cost-sharing may result in claim corrections and patient refunds.
Original notice
Breast cancer does not pause for pregnancy and postpartum
providernewsroom.com · Always check the source before changing claims.