News and Announcements

Cigna: Pass-through bills for laboratory services will be DENIED EFFECTIVE May 18, 2019

We want to make you aware that for claims processed on or after May 18, 2019, Cigna will deny bills for pass-through laboratory services. These are lab services submitted with modifier 90 in place of service (POS) 11 (office setting).
Pass-through billing occurs when providers bill for laboratory services they have not actually performed. For example, a provider draws blood in the office setting (POS 11), sends it to an outside laboratory for processing, and then bills Cigna for this service.
This change will affect all laboratory service codes billed with modifier 90 in POS 11.The processing laboratories should bill Cigna directly and be reimbursed according to a customer’s benefit plan.        For the full anouncement, click here