Cigna modified MM 0575 for radiofrequency ablation (RFA) of thyroid nodules, effective October 16, 2025. Here's what changes for billing teams.
Cigna Healthcare updated its coverage policy for thyroid nodule RFA under policy code MM 0575, with an effective date of October 16, 2025. The change directly affects CPT 60660 and CPT 60661 — the two codes used to bill percutaneous ablation of thyroid nodules. If your practice performs or refers for thyroid RFA, this policy revision changes what you need to document before those claims go out the door.
Quick-Reference Table
| Field | Detail |
|---|---|
| Payer | Cigna Healthcare |
| Policy | Radiofrequency Ablation (RFA) Thyroid Nodules |
| Policy Code | MM 0575 |
| Change Type | Modified |
| Effective Date | October 16, 2025 |
| Impact Level | High |
| Specialties Affected | Endocrinology, Interventional Radiology, Head & Neck Surgery, Otolaryngology |
| Key Action | Review medical necessity documentation requirements for CPT 60660 and 60661 before billing claims for dates of service on or after October 16, 2025 |
Cigna Thyroid Nodule RFA Coverage Criteria and Medical Necessity Requirements 2025
The Cigna thyroid nodule RFA coverage policy classifies CPT 60660 and CPT 60661 as medically necessary when the patient meets specific selection criteria. The policy language is direct: these codes are "considered medically necessary when criteria in the applicable coverage policy are met." That's the threshold your documentation has to clear.
What this means in practice: you can't bill 60660 or 60661 and assume medical necessity is self-evident from the diagnosis. Cigna will expect the clinical record to show the patient meets whatever criteria MM 0575 specifies. If your documentation doesn't map to those criteria, you're looking at a claim denial before you ever get to appeal.
CPT 60660 covers ablation of one or more thyroid nodules in one lobe or the isthmus, performed percutaneously with imaging guidance included. CPT 60661 is the add-on code for ablation in an additional lobe — same percutaneous, image-guided approach, but billed for each extra lobe beyond the first. These are not interchangeable. Using 60661 without 60660 on the same claim is a billing error.
Prior authorization requirements under this coverage policy are worth confirming before scheduling. Cigna's prior auth requirements for thyroid RFA procedures can vary by plan type and geography. Call to verify PA status on every case before the procedure date, especially for commercial plans. Don't assume the absence of a PA requirement in the policy document means PA isn't required for a specific patient's plan.
Reimbursement for 60660 and 60661 depends on medical necessity being established and documented. If the record doesn't support the criteria Cigna sets in MM 0575, you won't get paid — and a post-pay audit could trigger recoupment on claims you thought were closed.
Cigna Thyroid Nodule RFA Exclusions and Non-Covered Indications
The policy data available for MM 0575 does not specify a separate list of excluded or experimental indications in the summary provided. However, the structure of this coverage policy — tying coverage status directly to whether "criteria in the applicable coverage policy are met" — implies a binary: you either meet criteria or you don't.
If a nodule doesn't meet Cigna's size, symptom, or clinical threshold requirements (benign vs. malignant status, nodule characteristics, prior treatment history), expect a non-covered determination. The absence of an explicit exclusion list doesn't mean Cigna covers all presentations. It means any case outside the defined criteria falls to non-covered by default.
Talk to your compliance officer if your practice treats thyroid nodules with RFA across a wide range of presentations. The real risk here is billing 60660 or 60661 for cases that are clinically reasonable but don't fit Cigna's specific criteria. That gap between clinical judgment and payer criteria is where denials live.
Coverage Indications at a Glance
| Indication | Status | Relevant Codes | Notes |
|---|---|---|---|
| Ablation of thyroid nodule(s), one lobe or isthmus — when criteria met | Covered / Medically Necessary | CPT 60660 | Percutaneous, includes imaging guidance; criteria must be documented |
| Ablation of thyroid nodule(s), additional lobe — when criteria met | Covered / Medically Necessary | CPT 60661 | Add-on to 60660; billed per additional lobe; criteria must be documented |
| Thyroid nodule ablation — criteria not met | Not Covered | CPT 60660, 60661 | Claims without documented criteria support will deny |
Cigna Thyroid Nodule RFA Billing Guidelines and Action Items 2025
| # | Action Item |
|---|---|
| 1 | Audit your charge capture for CPT 60660 and 60661 before October 16, 2025. Pull any claims in your queue for thyroid RFA and verify the documentation maps to Cigna's medical necessity criteria under MM 0575. Claims for dates of service on or after the effective date need to meet the updated policy — don't let old documentation habits carry over. |
| 2 | Confirm prior authorization requirements for each Cigna plan before scheduling. PA requirements for thyroid RFA billing vary across Cigna's commercial, Medicare Advantage, and employer plan products. Call the number on the back of the card, or check Cigna's provider portal. Get the PA reference number and document it in the patient file before the procedure date. |
| 3 | Update your clinical documentation templates to reflect MM 0575 criteria. If your endocrinology or radiology team uses pre-built note templates for thyroid procedures, those templates need to capture whatever clinical criteria Cigna uses to establish medical necessity under this coverage policy. Work with your medical director to add the relevant fields now, before the effective date. |
| 4 | Train your billing team on the 60660 and 60661 code relationship. CPT 60661 is an add-on code. It cannot be billed standalone. The primary procedure — 60660 — must appear on the same claim for 60661 to process correctly. Misuse of these two codes is one of the cleaner paths to a claim denial, and it's fixable with a quick internal training session. |
| 5 | Review your denial patterns for thyroid ablation claims now. If you're already billing CPT 60660 or 60661 to Cigna and seeing denials, pull those Explanations of Benefits and look at the denial reason codes. With MM 0575 now modified, some denials you're seeing may be tied to criteria the updated policy addresses — or tightens. Understanding your current denial rate before October 16 gives you a baseline to measure whether the policy change helps or hurts your reimbursement picture. |
| 6 | Flag this policy change for your compliance officer if you bill high volumes of thyroid RFA. MM 0575 in the Cigna system is a criteria-based coverage policy. High-volume thyroid RFA practices have real financial exposure if documentation isn't airtight. This isn't a low-stakes change. If you're running 10 or more of these procedures per month to Cigna patients, get your compliance officer and billing consultant in the same room before the effective date. |
| Previous Version | Current Version |
|---|---|
| Coverage is considered experimental and investigational for all indications | Coverage is considered medically necessary when specific criteria are met |
| Prior authorization is not required | Prior authorization is required for initial treatment |
| Documentation must include clinical history | Documentation must include clinical history |
| Re-review every 24 months | Re-review every 12 months with updated clinical documentation |
CPT, HCPCS, and ICD-10 Codes for Thyroid Nodule RFA Under MM 0575
Covered CPT Codes (When Selection Criteria Are Met)
| Code | Type | Description |
|---|---|---|
| 60660 | CPT | Ablation of one or more thyroid nodule(s), one lobe or the isthmus, percutaneous, including imaging guidance |
| 60661 | CPT | Ablation of one or more thyroid nodule(s), additional lobe, percutaneous, including imaging guidance |
Note: MM 0575 does not list HCPCS Level II codes or ICD-10-CM diagnosis codes in the available policy data. The policy scope as published is limited to CPT 60660 and 60661. If your billing system requires ICD-10 code mapping for prior authorization or claim submission, work from the clinical record and Cigna's current diagnosis code requirements — do not assume code pairings based on prior policy versions.
Get the Full Picture for CPT 60660
Track this policy across versions, search 1,500+ policies by CPT code, and get real-time alerts when any payer changes coverage.