CommercialDocumentationHigh impact
New Reimbursement Policy for Coding and Billing Accuracy effective January 13, 2025
Cigna·Coding
Effective date
Jan 13, 2025
We identified it
Jun 19, 2026
Summary
Cigna Healthcare is implementing policy R46 effective January 13, 2025, which will deny reimbursement for claims with coding and billing errors including duplicate charges, incorrect coding, insufficient documentation, and services not properly documented. Claims must have complete supporting medical documentation or they will not be paid.
Action Required
By January 13, 2025: Billing team must implement enhanced claim review processes to ensure all claims have complete supporting medical documentation before submission. Update billing workflows to verify correct coding, eliminate duplicate charges, and confirm all services are properly documented in medical records. Train staff on the 22 specific error types that will result in claim denials. Review and strengthen documentation requirements for providers to prevent claim rejections.