Autonomic Nerve Function Testing - (0506) — MM 0506 | CIGNA Coverage Update

Cigna modified its autonomic nerve function testing coverage policy (MM 0506) effective February 14, 2026, covering CPT codes 95921, 95922, 95923, and 95924 when specific medical necessity criteria are met. Here's what changes for billing teams.

Cigna Healthcare updated MM 0506 in the Cigna autonomic nerve function testing coverage policy to clarify covered indications for sudomotor, cardiovagal, and adrenergic autonomic testing. The four affected CPT codes — 95921 (cardiovagal), 95922 (vasomotor adrenergic), 95923 (sudomotor), and 95924 (combined parasympathetic and sympathetic) — remain billable when criteria are met, but the ICD-10 diagnosis code list has been refined to 75 specific codes. If your practice bills for autonomic testing in neurology, endocrinology, or cardiology, this policy update affects your claim validation workflow now.

Quick-Reference Table

Cigna Autonomic Nerve Function Testing Coverage Criteria and Medical Necessity Requirements 2026

The Cigna MM 0506 Cigna coverage policy designates CPT codes 95921, 95922, 95923, and 95924 as medically necessary when selection criteria are met. The policy covers three categories of autonomic testing: cardiovagal (parasympathetic function), vasomotor adrenergic (sympathetic adrenergic function), and sudomotor testing.

Medical necessity for autonomic nerve function testing hinges on the presence of a qualifying diagnosis. Cigna ties coverage directly to the 75 ICD-10-CM codes listed in this policy. If the diagnosis on the claim doesn't match one of those codes, expect a claim denial — regardless of how clinically appropriate the test was.

The core covered indications span diabetic neuropathy (including Type 1, Type 2, drug-induced, and other specified diabetes with neurological complications), autonomic nervous system disorders, complex regional pain syndrome, amyloidosis, Guillain-Barré syndrome, POTS (G90.A), Sjögren syndrome with peripheral or central nervous system involvement, and syncope (R55). This is a clinically broad list — but it's also a hard boundary. Diagnoses outside this list will not support reimbursement for these codes under this coverage policy.

The policy does not specify prior authorization requirements within the MM 0506 document itself. That said, prior authorization requirements can vary by plan. Verify auth requirements at the individual plan level before scheduling autonomic testing, especially for complex regional pain syndrome or multi-system degeneration cases, which tend to draw more scrutiny.

Cigna Autonomic Nerve Function Testing Exclusions and Non-Covered Indications

The policy data doesn't explicitly enumerate a "not covered" CPT code list separate from the covered codes. All four CPT codes — 95921, 95922, 95923, 95924 — are covered when criteria are met.

The real exclusion mechanism here is the diagnosis code restriction. If you bill autonomic nerve function testing with a diagnosis outside the 75 approved ICD-10 codes, Cigna treats the claim as not meeting medical necessity criteria. That's functionally the same as a non-covered designation from a billing standpoint.

Watch for patients with vague or unspecified autonomic symptoms — G90.9 (Disorder of the autonomic nervous system, unspecified) is on the covered list, but G90.09 (Other idiopathic peripheral autonomic neuropathy) is also covered. Still, "unspecified" codes draw additional scrutiny during medical record review. Use the most specific diagnosis code available whenever the clinical documentation supports it.

Coverage Indications at a Glance

Cigna Autonomic Nerve Function Testing Billing Guidelines and Action Items 2026

CPT, HCPCS, and ICD-10 Codes for Autonomic Nerve Function Testing Under MM 0506

Covered CPT Codes (When Medical Necessity Criteria Are Met)

Key ICD-10-CM Diagnosis Codes

One thing worth calling out: serotonin syndrome (G90.81) appears on this approved list. That's not a code most billing teams think of alongside autonomic testing, but it makes clinical sense — autonomic instability is a core feature of serotonin syndrome. If your practice sees toxicology or emergency follow-up patients, make sure your team knows G90.81 is a valid pairing for these CPT codes.

If you're uncertain whether your patient mix or documentation practices support the criteria in MM 0506, talk to your compliance officer before the February 14, 2026 effective date. The diagnosis code list is specific enough that a focused internal audit now is far cheaper than a retroactive denial correction later.