Cell-Based Therapy for Cardiac and Peripheral Arterial Disease - (0287) — MM 0287 | CIGNA Coverage Update

Cigna modified MM 0287 covering cell-based therapy for cardiac and peripheral arterial disease, effective September 26, 2025. Every procedure in this policy — CPT 33999, 38206, 38232, 93799, and HCPCS C9782 and S2150 — is classified as experimental, investigational, or unproven. Here's what billing teams need to do.

Cigna Healthcare updated its cell-based therapy coverage policy under MM 0287 in September 2025. The policy covers proposed treatments for heart damage and peripheral arterial disease using several cell types, including autologous myoblasts, hematopoietic progenitor cells, and bone marrow-derived stem cells. The result is a blanket non-coverage position: no reimbursement for any of the six codes in this policy, regardless of clinical presentation.

Quick-Reference Table

Cigna Cell-Based Therapy Coverage Criteria and Medical Necessity Requirements 2025

The direct answer here: Cigna does not consider cell-based therapy for cardiac disease or peripheral arterial disease (PAD) to meet medical necessity. Full stop.

Under MM 0287 in the Cigna Healthcare system, procedures in this category do not have a covered pathway. There are no qualifying criteria that unlock reimbursement. The policy does not describe a clinical scenario where these treatments become covered services.

That matters for your prior authorization workflow. Some teams burn time submitting prior auth requests for procedures that a payer has already categorized as experimental. For any Cigna member presenting for cell-based cardiac or PAD therapy, the coverage policy answer is the same regardless of diagnosis code, provider specialty, or site of service. Don't request prior authorization expecting a different result — the experimental designation is the position, not a default you can appeal around with additional documentation.

The procedures addressed in this policy use several cell types as a proposed method to treat heart damage or peripheral arterial disease. The specific cell types include autologous myoblasts (skeletal muscle cells), blood-derived hematopoietic progenitor cells, and bone marrow-derived stem cells. All of them fall under the same non-coverage determination.

Cigna Cell-Based Therapy Exclusions and Non-Covered Indications

This is where the substance of MM 0287 lives. Every code in this policy carries the same classification: experimental, investigational, or unproven.

That classification matters beyond just this specific denial. Experimental and investigational designations typically mean Cigna will not cover the service even if the member has a serious, documented diagnosis. It also affects how you handle claim denial responses. An E/I/U denial is not a medical necessity denial — the appeal pathway is different, and the supporting documentation required is different.

If your clinical team is pushing back on denials for these procedures, make sure your appeals team understands the distinction. You're not arguing clinical appropriateness against a coverage criterion. You're arguing that the technology or procedure meets the standard for coverage under Cigna's definition — a much harder bar and a different argument entirely.

The real risk here is for practices exploring newer cardiac regenerative therapies or participating in studies where billing occurs. If your organization is involved in any program that touches these cell types for cardiac or PAD indications and bills Cigna, audit those claims now.

Coverage Indications at a Glance

Cigna Cell-Based Therapy Billing Guidelines and Action Items 2025

CPT, HCPCS, and ICD-10 Codes for Cell-Based Therapy Under MM 0287

The policy data for MM 0287 contains no covered codes. All six codes in this policy carry an experimental, investigational, or unproven designation. There are no ICD-10 diagnosis codes listed in the policy data.

Experimental / Investigational / Unproven CPT Codes

Experimental / Investigational / Unproven HCPCS Codes

One note on the unlisted codes — CPT 33999 and 93799 are catch-all unlisted procedure codes. Their use for cell-based therapy is specifically called out as non-covered here, but these codes appear across many cardiac and cardiovascular procedures. The E/I/U status applies when used in the context of cell-based therapy for cardiac repair or PAD. Your billing team should not interpret this as a blanket non-coverage of all 33999 or 93799 submissions.

Similarly, CPT 38206 and 38232 and HCPCS S2150 are used in bone marrow transplant and stem cell harvest contexts that may be covered under entirely different policies. The non-coverage designation under MM 0287 is specific to cell-based therapy for cardiac and peripheral arterial disease. If you bill these codes for oncology or transplant indications, this policy does not govern that.