CommercialPrior AuthHigh impact
Spine surgery and related procedures added to musculoskeletal precertification program managed by EviCore by Evernorth
Cigna·Orthopedics, Neurosurgery, Pain Management·Coding
Effective date
Nov 1, 2024
We identified it
Jun 19, 2026
Summary
Effective November 1, 2024, Cigna Healthcare requires precertification through EviCore's CareCore portal for spine surgeries including decompression procedures, spinal fusions, vertebroplasty/kyphoplasty, and disc arthroplasty. This replaces previous authorization processes and requires new portal registration and workflow changes.
Action Required
By November 1, 2024: Billing and scheduling staff must register for EviCore CareCore portal at EviCore.com/Provider and begin submitting spine surgery precertifications through this new system (phone: 866.668.9250, fax: 855.774.1319). Update scheduling workflows to obtain precertification before all spine surgeries in office, inpatient, or outpatient settings. Continue using MedSolutions portal for joint procedures and pain management. Attend EviCore orientation sessions in October-November to understand new requirements. Failure to obtain precertification will result in claim denials.