Cigna CT Cervical Spine without contrast prior authorization requirements (2026)
What Cigna generally requires to approve CT Cervical Spine without contrast (CPT 72125), for Commercial plans. Yes. Cigna generally requires prior authorization for CT Cervical Spine without contrast (CPT 72125).
Medical-necessity criteria Cigna generally applies
[NEEDS CLINICAL SPOT-CHECK] Prior authorization required; Cigna delegates high-tech spine imaging to eviCore by Evernorth. For uncomplicated neck/back pain, advanced imaging (MRI preferred; CT when MRI is contraindicated/equivocal or for bony pathology) requires an in-person clinical evaluation and a documented failed trial of ~6 weeks of provider-directed conservative therapy. Red-flag indications bypass the conservative-care requirement: motor weakness, cauda equina syndrome, suspected cancer, fracture, infection, severe radicular pain, aortic aneurysm/dissection.
How to submit
- Method: eviCore by Evernorth (portal)
Sources & verification
- BindingSource — Cigna Spine Imaging Guidelines (V1.0.2026 (SP-1.0)) · effective 2026-02-03.View
Binding = the payer's own policy. Proxy = a public, evidence-based clinical guideline the payer mirrors. Portal-only = the binding criteria are confirmed in the administrator's portal. Always confirm against the payer for the member's specific plan. Last verified 2026-06-28.
Frequently asked questions
Does Cigna require prior authorization for CT Cervical Spine without contrast?
Yes. Cigna generally requires prior authorization for CT Cervical Spine without contrast (CPT 72125).
What does Cigna require to approve CT Cervical Spine without contrast?
[NEEDS CLINICAL SPOT-CHECK] Prior authorization required; Cigna delegates high-tech spine imaging to eviCore by Evernorth. For uncomplicated neck/back pain, advanced imaging (MRI preferred; CT when MRI is contraindicated/equivocal or for bony pathology) requires an in-person clinical evaluation and a documented failed trial of ~6 weeks of provider-directed conservative therapy. Red-flag indication… Always confirm against the current Cigna policy.
How long does a Cigna prior authorization take?
Turnaround varies by plan and submission method. Check the Cigna portal for current timeframes.
Submitting CT Cervical Spine without contrast to Cigna?
Praxigen checks your clinical note against these criteria before you submit and drafts a policy-cited appeal if it is denied. You review and submit; nothing is sent automatically.