Peripheral Nerve Destruction for Pain Conditions - (0525) — MM 0525 | CIGNA Coverage Update

Cigna modified MM 0525 for peripheral nerve destruction, effective March 7, 2026. Every CPT and HCPCS code in this policy is classified as Not Medically Necessary. Here's what billing teams need to do.

Cigna Healthcare updated Coverage Policy MM 0525 on March 7, 2026, covering peripheral nerve destruction procedures used for pain management. The policy addresses percutaneous cryoablation and other ablation techniques — electrical, laser, chemical, and radiofrequency. All eight CPT codes (0440T, 0441T, 0442T, 64620, 64624, 64632, 64640, and 64999) and both HCPCS codes (C9808 and C9809) carry a blanket "Not Medically Necessary" designation across 578 ICD-10-CM diagnosis codes. That's a broad coverage wall. If your practice bills these services for Cigna members, read this closely.

Quick-Reference Table

Cigna Peripheral Nerve Destruction Coverage Criteria and Medical Necessity Requirements 2026

The Cigna peripheral nerve destruction coverage policy under MM 0525 takes a hard stance. Every procedure covered by this policy — percutaneous cryoablation, neurolytic agent destruction, radiofrequency ablation of peripheral nerves, and related techniques — is considered Not Medically Necessary for the full list of indicated diagnoses.

That list is enormous. The 578 ICD-10-CM codes span migraine variants (G43.001 through G43.919), headache syndromes (G44.001–G44.89), brachial and lumbosacral plexus disorders (G54.0, G54.1), cervical and lumbosacral root disorders (G54.2, G54.4), upper extremity mononeuropathies (G56.00–G56.93), and lower extremity nerve lesions including sciatic nerve disorders (G57.00–G57.03), meralgia paresthetica (G57.10–G57.13), and tarsal tunnel syndrome (G57.50–G57.53).

The policy covers procedures performed alone or in combination. That matters for billing. If you're combining cryoablation (0440T, 0441T, or 0442T) with a neurolytic agent technique (64640), Cigna treats both as Not Medically Necessary — not just one.

The policy does not list prior authorization as a pathway to coverage. There's no prior auth process that unlocks reimbursement here. The designation is categorical. That's different from a policy that says "covered with prior authorization" — this one says it's not medically necessary, full stop.

If you're unsure how this applies to your patient mix or your specific plan contracts, talk to your compliance officer before billing.

Cigna Peripheral Nerve Destruction Exclusions and Non-Covered Indications

Every indication in this policy is excluded. That's the real issue with MM 0525.

Cigna deems percutaneous cryoablation of upper extremity distal and peripheral nerves (0440T), lower extremity distal and peripheral nerves (0441T), and nerve plexus or other truncal nerves (0442T) as Not Medically Necessary. Same for destruction by neurolytic agent of the intercostal nerve (64620), genicular nerve branches (64624), plantar common digital nerve (64632), and other peripheral nerve or branch (64640). Unlisted nervous system procedures billed under 64999 also fall here.

On the supply side, C9808 (nerve cryoablation probe — devices like cryoICE, cryoSPHERE, and cryoSPHERE MAX) and C9809 (cryoablation needle systems like the iovera system, including all disposable components) are both Not Medically Necessary under this policy.

The clinical scope is wide. Headache, occipital neuralgia, joint pain, neuropathic pain, and nerve entrapment syndromes all appear in the diagnosis list — and all are non-covered. This isn't a narrow carve-out for one technique. This covers the full toolkit of peripheral nerve ablation for pain.

Coverage Indications at a Glance

Cigna Peripheral Nerve Destruction Billing Guidelines and Action Items 2026

The effective date of March 7, 2026 is already here. These aren't future changes to plan for — they're current policy. Act now.

CPT, HCPCS, and ICD-10 Codes for Peripheral Nerve Destruction Under MM 0525

Not Covered CPT Codes

All CPT codes under MM 0525 carry a Not Medically Necessary designation. There are no covered CPT codes in this policy.

Not Covered HCPCS Codes

Key ICD-10-CM Diagnosis Codes

The full policy list contains 578 ICD-10-CM codes. The table below includes the primary categories. Review the full policy at Cigna's source document for the complete list.

The full policy includes 578 ICD-10-CM codes. The complete list is available in the source policy document.