Cigna has announced that it will implement a musculoskeletal precertification program beginning January 1, 2016. According to a letter sent to AAHKS, “ordering physicians will need to request precertification directly through eviCore for certain musculoskeletal services, including interventional pain management and major joint surgery services related to the hip, knee, and shoulder.” Cigna has partnered with eviCore Healthcare (formerly MedSolutions) to have the precertification reviews performed by orthopaedic surgeons.
Cigna is asking that AAHKS members review the medical necessity criteria on the eviCore website and contact David E. Mino, MD, MBA, Cigna National Medical Director Orthopaedic Surgery and Spinal Disorders, at david.mino@Cigna.com with any questions. The Evidence-Based Medicine Committee, under the leadership of Chick Yates, MD also will review the criteria on behalf of AAHKS.