Bone Mineral Density Measurement - (0300) | CIGNA Coverage Update

Summary: Cigna Healthcare modified its Bone Mineral Density Measurement coverage policy (Policy 0300), effective April 16, 2026. Here's what billing teams need to know before that date.

Cigna Healthcare updated Policy 0300 governing bone mineral density (BMD) measurement coverage. The policy does not list specific CPT or HCPCS codes in the data available at publication time — we'll cover what that means for your workflow below. If your practice bills for DEXA scans or other bone density testing, review this policy change before the April 16, 2026 effective date.

Quick-Reference Table

Cigna Bone Mineral Density Measurement Coverage Criteria and Medical Necessity Requirements 2026

Cigna's bone mineral density measurement coverage policy under Policy 0300 has been modified as of April 16, 2026. The policy data available at publication does not include a detailed summary of the specific changes Cigna made in this revision. That's a problem for billing teams — and we'll address it directly.

What we do know: BMD measurement policies typically hinge on medical necessity criteria tied to patient risk factors, diagnosis codes, and clinical guidelines from organizations like the U.S. Preventive Services Task Force (USPSTF) and the National Osteoporosis Foundation. Cigna's coverage policy in this area has historically required documented indications before reimbursement is approved.

Medical necessity for BMD testing under Cigna policies generally centers on defined patient populations. These include postmenopausal women, patients on long-term corticosteroid therapy, individuals with a history of fragility fractures, and patients with conditions known to affect bone density — such as hyperparathyroidism or malabsorption syndromes. Whether this modification tightens or loosens those criteria is exactly what you need to confirm by pulling the full Policy 0300 document directly from Cigna's coverage policy portal.

Prior authorization requirements for BMD testing vary by Cigna plan type. Some commercial plans require prior auth for repeat testing; others don't. If your practice performs baseline and follow-up scans, check whether the updated policy changes the frequency limitations or prior authorization triggers for your patient population.

Because the detailed policy language is not included in the data available here, billing teams should treat this as a signal to act — not a complete answer. Pull the source document at the link above. Compare it line by line against the previous version.

Cigna Bone Mineral Density Measurement Exclusions and Non-Covered Indications

Without the full policy text in hand, we can't list Cigna's specific exclusions as modified in this version. That said, Cigna's historical BMD coverage policy has excluded certain indications from reimbursement — and those exclusions are where claim denial risk concentrates.

Common non-covered indications in BMD policies include: routine screening in low-risk younger patients without documented risk factors, repeat testing within frequency limits without a documented change in clinical status, and testing performed outside the approved clinical settings. Whether Policy 0300 modifies any of these exclusions is information your billing team needs before April 16, 2026.

If your practice has seen BMD claim denials from Cigna in the past 12 months, look at the denial reason codes. A policy modification on medical necessity criteria often follows a pattern of increased denials — Cigna may be formalizing criteria that adjusters have already been applying informally. That's a pattern worth checking.

Coverage Indications at a Glance

Because the detailed policy summary was not available in the source data for this article, we cannot build a complete indications table from the Policy 0300 document. The table below reflects the general structure of Cigna BMD coverage as documented in prior policy versions. Treat this as a starting framework — not a substitute for the current policy text.

Pull the actual Policy 0300 document to confirm every row in this table. Cigna modified this policy on April 16, 2026 — prior version criteria may no longer apply.

Cigna Bone Mineral Density Billing Guidelines and Action Items 2026

Here's what your billing team should do now.

Bone mineral density billing is not a high-complexity area in isolation — but coverage policy modifications that touch medical necessity criteria can shift your denial rate fast. A change that narrows the covered population by one indication category can affect dozens of claims per month at a mid-size endocrinology or rheumatology practice.

CPT, HCPCS, and ICD-10 Codes for Bone Mineral Density Measurement Under Policy 0300

The policy data provided for this article does not list specific CPT, HCPCS, or ICD-10 codes. We will not invent codes here.

That's not a reason to stop — it's a reason to go to the source. Pull Policy 0300 directly from Cigna's portal and look for the code appendix or applicable codes section. Cigna's coverage policies almost always include a code table, and that's where you'll find the exact CPT codes covered under this policy.

Commonly Associated Codes for BMD Testing (for Research Reference Only)

The following codes are commonly associated with bone mineral density measurement in the industry. Do not bill these codes based on this list alone. Verify that each code appears in the updated Policy 0300 document before using them for Cigna claims.

If you're looking for the full code list, the Policy 0300 source document is linked above this article. That's the only reliable source for this specific policy revision.