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    v1.0.28
    OpenPayerPolicy UpdatesCardiologyCigna Cardiac Device Coverage Update | OpenPayer
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    ModifiedCignaPolicy 0574

    Cardiac Omnibus Codes

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    This policy governs coverage of six cardiac-related devices and procedures, including pressure sensors, cardiac contractility modulation, baroreflex activation, and heart failure monitoring. It applies to health benefit plans administered by Cigna Companies, subject to the applicable benefit plan, laws, regulations, and case-specific clinical review.

    OpenPayer is powered by Trek Health's payer performance platform. Trek continuously ingests, validates, and normalizes Transparency in Coverage data alongside payer policies and other commercial payer data to create a structured payer intelligence foundation. OpenPayer uses this foundation to deliver personalized search results, dynamically generated policy pages, and tailored policy monitoring based on each user's payers, specialties, billing codes, and areas of interest. The same intelligence powers broader payer performance workflows, including reimbursement benchmarking, contract evaluation, payer negotiations, and financial decision-making.

    Policy Summary
    PayerCigna
    PolicyCardiac Omnibus Codes
    Policy CodePolicy 0574
    Change TypeModified
    Effective DateSep 15, 2026
    Next Review DateSep 15, 2027
    Key ActionDocument the selected device, applicable FDA indication, heart-failure classification, and relevant eligibility requirements before submitting the request.
    SourceLink
    POLICY UPDATE CHANGES

    The policy added CPT code 1050T and a corresponding policy statement.

    The policy added CPT code 64654.

    The policy added a policy statement for an inferior vena cava sensor.

    The policy revised the policy statement for a carotid sinus baroreflex activation device.

    The annual review reported no coverage statement changes.

    6Cardiac device or procedure categories addressed
    6Services classified as experimental, investigational, or unproven
    2CPT codes added
    4Policy statement changes or additions

    Covered Services and Coverage Limitations

    Carotid Sinus Baroreflex Activation Device

    The service is considered experimental, investigational, or unproven.

    Carotid sinus baroreflex activation device using CPT 64654 or HCPCS C1825 is considered experimental, investigational, or unproven.

    Left Atrial Pressure Sensor

    The service is considered experimental, investigational, or unproven.

    Left atrial pressure sensor: Implantation and monitoring of a left atrial pressure sensor using CPT 0933T is considered experimental, investigational, or unproven.

    Pulmonary Artery Pressure Sensor

    The service is considered experimental, investigational, or unproven.

    Pulmonary artery pressure sensor: Implantation and monitoring of a pulmonary artery pressure sensor using CPT 33289 or HCPCS C2624 or G0555 is considered experimental, investigational, or unproven.

    Cardiac Contractility Modulation Therapy

    The service is considered experimental, investigational, or unproven.

    Cardiac contractility modulation therapy: Use of cardiac contractility modulation therapy using CPT 0408T, 0915T-0918T, 0930T-0931T, or HCPCS C1824 is considered experimental, investigational, or unproven.

    Inferior Vena Cava Sensor

    The service is considered experimental, investigational, or unproven.

    Inferior vena cava sensor: Implantation and monitoring of an inferior vena cava sensor using CPT 0981T is considered experimental, investigational, or unproven.

    Heart Failure Decompensation Sensor

    The service is considered experimental, investigational, or unproven.

    Heart failure decompensation sensor: Use of a subcutaneous heart failure decompensation sensor or monitoring using CPT 1050T is considered experimental, investigational, or unproven.

    Experimental, Investigational, or Unproven Technologies

    The listed services and products are considered experimental, investigational, or unproven.

    Experimental, investigational, or unproven cardiac technology: The service or product is a carotid sinus baroreflex activation device, left atrial pressure sensor, pulmonary artery pressure sensor, cardiac contractility modulation therapy or system, or inferior vena cava sensor identified in the corresponding coding section.

    The associated codes are designated experimental, investigational, or unproven.

    Deleted codes and codes that are not effective on the date the service is rendered may not be eligible for reimbursement. Verify current code status and effective dates before submitting a claim.

    The BAROSTIM NEO system is contraindicated for patients with bilateral carotid bifurcations above the level of the mandible, baroreflex failure or autonomic neuropathy, uncontrolled symptomatic cardiac bradyarrhythmias, carotid atherosclerosis of > 50%, ulcerative carotid plaques, or a known allergy to silicone or titanium.

    The Cordella Pulmonary Artery Sensor System is contraindicated for patients who are unable to take dual antiplatelet or anticoagulant therapy for one month after implantation.

    The HeartPOD System, Promote LAP System, and V-LAP left atrial pressure sensor devices are identified as devices without full FDA approval for clinical use.

    Other devices designed to assess cardiac output through pressure changes in the pulmonary artery or right ventricular outflow tract have been studied, but none are FDA approved.

    Transcatheter implantation of a wireless inferior vena cava sensor reported with CPT 0981T is considered experimental, investigational, or unproven. The code describes long-term hemodynamic monitoring and includes sensor deployment, radiological supervision and interpretation, right heart catheterization, and inferior vena cava venography when performed.

    Insertion of a subcutaneous heart failure decompensation monitor reported with CPT 1050T is considered experimental, investigational, or unproven. The monitor contains sensors that measure, at a minimum, heart rate, impedance, respiration rate, physical activity, and heart sounds.

    Procedure and Device Coding

    Carotid Sinus Baroreflex Activation DevicemixedExperimental
    64654Carotid sinus baroreflex activation device
    C1825Carotid sinus baroreflex activation device
    Left Atrial Pressure SensorCPTExperimental
    0933TImplantation and monitoring of a left atrial pressure sensor
    Pulmonary Artery Pressure SensormixedExperimental
    33289Implantation and monitoring of a pulmonary artery pressure sensor
    C2624Implantation and monitoring of a pulmonary artery pressure sensor
    G0555Implantation and monitoring of a pulmonary artery pressure sensor
    Cardiac Contractility Modulation TherapymixedExperimental
    0408TUse of cardiac contractility modulation therapy
    0915T-0918TUse of cardiac contractility modulation therapy
    0930T-0931TUse of cardiac contractility modulation therapy
    C1824Use of cardiac contractility modulation therapy
    Inferior Vena Cava SensorCPTExperimental
    0981TImplantation and monitoring of an inferior vena cava sensor
    Heart Failure Decompensation SensorCPTExperimental
    1050TUse of subcutaneous heart failure decompensation sensor/monitoring
    Carotid Sinus Baroreflex Activation Device — Experimental/Investigational/UnprovenmixedExperimental
    64654Initial open implantation of baroreflex activation therapy (BAT) modulation system, including lead placement onto the carotid sinus, lead tunnelling, connection to a pulse generator placed in a distant subcutaneous pocket (ie, total system), and intraoperative interrogation and programming. Implantation or replacement of carotid sinus baroreflex activation device; total.
    0266TImplantation or replacement of carotid sinus baroreflex activation device; total system (includes generator placement, unilateral or bilateral lead placement, intra-operative interrogation, programming, and repositioning, when performed) (code deleted 12/31/2025)
    0268TImplantation or replacement of carotid sinus baroreflex activation device; pulse generator only (includes intra-operative interrogation, programming, and repositioning, when performed) (code deleted 12/31/2025)
    C1825Generator, neurostimulator (implantable), nonrechargeable with carotid sinus baroreceptor stimulation lead(s)
    Left Atrial Pressure Sensor — Experimental/Investigational/UnprovenCPTExperimental
    0933TTranscatheter implantation of wireless left atrial pressure sensor for long-term left atrial pressure monitoring, including sensor calibration and deployment, right heart catheterization, transseptal puncture, imaging guidance, and radiological supervision and interpretation
    Pulmonary Artery Pressure Sensor — Experimental/Investigational/UnprovenmixedExperimental
    33289Transcatheter implantation of wireless pulmonary artery pressure sensor for long-term hemodynamic monitoring, including deployment and calibration of the sensor, right heart catheterization, selective pulmonary catheterization, radiological supervision and interpretation, and pulmonary artery angiography, when performed
    C2624Implantable wireless pulmonary artery pressure sensor with delivery catheter, including all system components
    G0555Provision of replacement patient electronics system (e.g., system pillow, handheld reader) for home pulmonary artery pressure monitoring
    Cardiac Contractility Modulation Therapy — Experimental/Investigational/UnprovenmixedExperimental
    0408TInsertion or replacement of permanent cardiac contractility modulation system, including contractility evaluation when performed, and programming of sensing and therapeutic parameters; pulse generator with transvenous electrodes.
    0915TInsertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; pulse generator and dual transvenous electrodes/leads (pacing and defibrillation).
    0916TInsertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; pulse generator only.
    0917TInsertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; single transvenous lead (pacing or defibrillation) only.
    0918TInsertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; dual transvenous leads (pacing and defibrillation) only.
    0930TElectrophysiologic evaluation of cardiac contractility modulation-defibrillator leads, including defibrillation-threshold evaluation (induction of arrhythmia, evaluation of sensing and therapy for arrhythmia termination), at time of initial implantation or replacement with testing of cardiac contractility modulation-defibrillator pulse generator.
    0931TElectrophysiologic evaluation of cardiac contractility modulation-defibrillator leads, including defibrillation-threshold evaluation (induction of arrhythmia, evaluation of sensing and therapy for arrhythmia termination), separate from initial implantation or replacement with testing of cardiac contractility modulation-defibrillator pulse generator.
    C1824Generator, cardiac contractility modulation (implantable)
    Inferior Vena Cava Sensor — Experimental/Investigational/UnprovenCPTExperimental
    0981TTranscatheter implantation of wireless inferior vena cava sensor for long-term hemodynamic monitoring, including deployment of the sensor, radiological supervision and interpretation, right heart catheterization, and inferior vena cava venography, when performed (Do not report 0981T in conjunction with 36010, 36013, 37252, 37253, 75825, 76000, 93451, 93453, 93456, 93460, 93461, 93566, 93593, 93594, 93596, 93597) (For implantation of wireless pulmonary artery sensor, use 33289) (For remote monitoring of an implantable inferior vena cava pressure sensor, use 0982T)
    Inferior Vena Cava Sensor — Experimental/Investigational/UnprovenCPTExperimental
    0981TTranscatheter implantation of wireless inferior vena cava sensor for long-term hemodynamic monitoring, including deployment of the sensor, radiological supervision and interpretation, right heart catheterization, and inferior vena cava venography, when performed.
    Heart Failure Decompensation Sensor — Experimental/Investigational/UnprovenCPTExperimental
    1050TInsertion, subcutaneous heart failure decompensation monitor, containing sensors that measure, at a minimum, heart rate, impedance, respiration rate, physical activity, heart sounds.
    Referenced Cardiac Procedure CodesCPT
    36010Referenced as a code that should not be reported in conjunction with 0981T.
    36013Referenced as a code that should not be reported in conjunction with 0981T.
    37252Referenced as a code that should not be reported in conjunction with 0981T.
    37253Referenced as a code that should not be reported in conjunction with 0981T.
    75825Referenced as a code that should not be reported in conjunction with 0981T.
    76000Referenced as a code that should not be reported in conjunction with 0981T.
    93451Referenced as a code that should not be reported in conjunction with 0981T.
    93453Referenced as a code that should not be reported in conjunction with 0981T.
    93456Referenced as a code that should not be reported in conjunction with 0981T.
    93460Referenced as a code that should not be reported in conjunction with 0981T.
    1–10 of 18
    1/2
    CPT coding updatesCPT
    1050TAdded CPT code with corresponding policy statement
    64654Added CPT code
    BAROSTIM NEO indication
    DeviceBAROSTIM NEO baroreflex activation system
    Left ventricular ejection fraction≤ 35%
    Applicable populationPatients remaining symptomatic despite guideline-directed medical therapy who are NYHA Class III or Class II with a recent history of Class III
    BAROSTIM NEO and BeAT-HF population

    Documentation, Billing, and Denial Risks

    Documentation Required

    Verify FDA Indication and Eligibility

    Before requesting or billing implantation of the Cordella™ Pulmonary Artery Sensor System, verify that the patient meets the FDA-labeled indication: NYHA Class III heart failure, non-hospitalized, stable on diuretics and guideline-directed medical therapy (GDMT) for at least 30 days. The system received FDA PMA approval on June 20, 2024 (P230040), with an ongoing post-approval study requirement.

    • FDA-labeled use: measure, record, and transmit pulmonary artery pressure data.
    • The FDA-approved Cordella system includes the PA Sensor, Delivery System, myCordella Handheld Patient Reader and Dock, Calibration Equipment, and Data Analysis Platform.
    • Document the applicable FDA indication and patient eligibility in the medical record.
    Billing Rule

    Policy Scope and Clinical Context

    This policy addresses implantable and monitoring technologies intended to measure cardiac or vascular pressures, support cardiac contractility, activate the carotid sinus baroreflex, or detect heart failure decompensation. The technologies include carotid sinus baroreflex activation, left atrial pressure sensing, pulmonary artery pressure sensing, cardiac contractility modulation, inferior vena cava sensing, and subcutaneous heart failure decompensation monitoring.

    Clinical and Technology Definitions

    NYHA Class I
    Heart diseasePatients have heart disease
    Physical activityThere is no resulting limitation of physical activity
    SymptomsOrdinary physical activity does not cause heart-failure symptoms such as fatigue or dyspnea
    NYHA Class II
    Heart diseasePatients have heart disease
    Physical activityThere is slight limitation of physical activity
    SymptomsHeart-failure symptoms develop with ordinary activity but not at rest
    Policy Summary
    PayerCigna
    PolicyCardiac Omnibus Codes
    Policy CodePolicy 0574
    Change TypeModified
    Effective DateSep 15, 2026
    Next Review DateSep 15, 2027
    Key ActionDocument the selected device, applicable FDA indication, heart-failure classification, and relevant eligibility requirements before submitting the request.
    SourceLink
    On This Page
    Covered Services and Coverage LimitationsProcedure and Device CodingDocumentation, Billing, and Denial RisksPolicy Scope and Clinical ContextClinical and Technology Definitions
    BiomarkerNT-proBNP < 1,600 pg/mL
    Trial populationNYHA functional class III, or NYHA functional class II with a recent history of NYHA functional class III
    CRT statusPatients are excluded when indicated for cardiac resynchronization therapy according to AHA/ACC/ESC guidelines
    CardioMEMS indication
    DeviceCardioMEMS HF System
    Heart-failure classNYHA Class II or III heart failure
    Eligibility triggerHospitalized for heart failure in the previous year and/or has elevated natriuretic peptides
    Cordella therapy
    DeviceCordella Pulmonary Artery Sensor System
    Treatment stabilityStable on diuretics and guideline-directed medical therapy for at least 30 days
    Patient populationNon-hospitalized patients with NYHA Class III heart failure
    Cordella post-implant requirement
    Required therapyDual antiplatelet or anticoagulant therapy
    DurationOne month after implantation
    ContraindicationInability to take the required dual antiplatelet or anticoagulant therapy

    Use Covered Codes and Follow the Benefit Plan

    Coverage and reimbursement depend on the applicable benefit plan and the policy criteria in effect on the date of service. Submit the most appropriate, current covered diagnosis and procedure codes; claims without applicable covered codes may be denied as not covered.

    • Review the member’s specific benefit plan because plan terms may supersede this policy.
    • Use codes that are effective on the submission date and supported by the documentation.
    • Confirm covered diagnosis and procedure codes before submitting the claim.
    Denial Risk

    Experimental or Unproven Cardiac Services

    Cigna considers the following cardiac services experimental, investigational, or unproven. Do not assume coverage based on clinical use or device availability; requests and claims for these services may be denied as not covered.

    • Carotid sinus baroreflex activation device.
    • Left atrial pressure sensor implantation and monitoring.
    • Pulmonary artery pressure sensor implantation and monitoring.
    • Cardiac contractility modulation therapy.
    • Inferior vena cava sensor implantation and monitoring.
    • Subcutaneous heart failure decompensation sensor/monitoring.
    Denial Risk

    Affected Cardiac Technologies and Procedures

    The following cardiac technologies and related procedures are identified as experimental, investigational, or unproven under the policy. Verify coverage before scheduling, obtaining authorization, or billing these services.

    • Carotid sinus baroreflex activation: CPT 64654, 0266T, 0268T; HCPCS C1825.
    • Left atrial pressure sensor: CPT 0933T.
    • Pulmonary artery pressure sensor: CPT 33289; HCPCS C2624 and G0555.
    • Cardiac contractility modulation: CPT 0408T, 0915T-0918T, 0930T-0931T; HCPCS C1824.
    • Inferior vena cava sensor: CPT 0981T.
    • The policy identifies these device and procedure categories as experimental, investigational, or unproven, creating denial risk when billed.
    Billing Rule

    Check Code Status Before Billing

    Do not rely on a deleted or inactive code for reimbursement. Confirm that each code is current and effective on the date the service is rendered, because deleted or otherwise inactive codes may not be eligible for reimbursement.

    • AMA and CMS code updates may occur more frequently than policy updates.
    • Validate code status and effective dates before claim submission.
    Denial Risk

    Inferior Vena Cava Sensor Is Unproven — CPT 0981T

    Cigna considers implantation and monitoring of an inferior vena cava sensor experimental, investigational, or unproven. Claims involving CPT 0981T are therefore at risk for denial as not covered.

    • CPT 0981T: transcatheter implantation of a wireless inferior vena cava sensor for long-term hemodynamic monitoring.
    • The code includes sensor deployment, radiological supervision and interpretation, right heart catheterization, and inferior vena cava venography when performed.
    • Do not report 0981T with 36010, 36013, 37252, 37253, 75825, 76000, 93451, 93453, 93456, 93460, 93461, 93566, 93593, 93594, 93596, or 93597.
    • For remote monitoring of an implantable inferior vena cava pressure sensor, use 0982T; for implantation of a wireless pulmonary artery sensor, use 33289.
    Denial Risk

    Heart Failure Decompensation Monitor Is Unproven — CPT 1050T

    Cigna considers use of a subcutaneous heart failure decompensation sensor or monitoring system experimental, investigational, or unproven. Claims involving CPT 1050T are at risk for denial as not covered.

    • CPT 1050T: insertion of a subcutaneous heart failure decompensation monitor containing sensors that measure, at minimum, heart rate, impedance, respiration rate, physical activity, and heart sounds.
    Documentation Required

    Post-Implant Antithrombotic Therapy Required

    Before implanting the Cordella Pulmonary Artery Sensor System, confirm that the patient can take dual antiplatelet therapy or anticoagulants for one month after implantation. Inability to do so is an FDA-listed contraindication and should be documented as part of the eligibility review.

    • Document the planned post-implant antithrombotic regimen and the patient’s ability to complete one month of therapy.
    • Do not implant the Cordella system when the patient cannot take dual antiplatelet therapy or anticoagulants for one month post implant.
    NYHA Class III
    Heart diseasePatients have heart disease
    Physical activityThere is marked limitation of physical activity
    SymptomsHeart-failure symptoms develop with less than ordinary physical activity but not at rest
    NYHA Class IV
    Physical activityPatients are unable to carry on any physical activity without discomfort
    Symptoms at restHeart-failure symptoms may occur even at rest
    Functional limitationThe condition represents the most severe NYHA functional class described in the policy
    Baroreflex activation therapy
    Therapy typeA device-based approach that activates the carotid sinus baroreflex
    Implanted componentsA pulse generator implanted in the pectoral region and leads placed adjacent to the carotid sinus
    Therapeutic actionElectrical pulses are delivered to the carotid baroreceptors
    Pulmonary artery pressure sensor
    Device typeAn implantable hemodynamic monitoring system
    MeasurementWirelessly measures pulmonary artery pressure
    Clinical useMay transmit pressure data for heart-failure management
    Pulmonary artery pressure sensor and remote monitoring system
    Device typeAn implantable device
    MeasurementsWirelessly measures pulmonary artery pressure and, in some systems, heart rate
    Monitoring useTransmits data for remote heart-failure management
    NYHA functional Class III heart failure
    Functional limitationMarked limitation of physical activity
    SymptomsSymptoms develop with less than ordinary physical activity but not at rest
    Cordella populationThe Cordella indication specifically identifies non-hospitalized NYHA Class III patients
    Cordella Pulmonary Artery Sensor System
    Primary functionMeasures, records, and transmits pulmonary artery pressure data
    Implanted componentCordella PA Sensor
    System componentsIncludes the delivery system, myCordella handheld patient reader and dock, calibration equipment, and data analysis platform
    Cardiac contractility modulation
    Therapy typeA device-based therapy using non-excitatory electrical pulses
    TimingSignals are delivered during the cardiac absolute refractory period
    EffectEnhances the strength of cardiac muscle contraction and is distinct from pacemaker or defibrillator rhythm control
    Wireless pulmonary artery pressure monitoring
    System typeAn implanted hemodynamic monitoring system
    MeasurementWirelessly measures pulmonary artery pressure
    Clinical statusIts usefulness in selected patients with NYHA Class III heart failure remains uncertain
    OPTIMIZER Smart system
    ManufacturerImpulse Dynamics
    Device typeAn implantable cardiac contractility modulation device system
    Regulatory statusThe OPTIMIZER Smart system received FDA premarket approval; the CCM-D HF System combining CCM with ICD therapy is not FDA approved
    Cardiac contractility modulation
    Therapy typeA device-based therapy using electrical signals
    Signal characteristicsRelatively high-voltage, long-duration signals are applied to the right ventricular septal wall
    Timing and effectSignals are delivered during the absolute myocardial refractory period to augment left ventricular contractile performance
    Inferior vena cava sensor
    Device typeAn implantable monitoring technology
    MeasurementsMeasures inferior vena cava area and collapsibility
    Clinical purposeAssesses fluid volume and anticipates heart-failure decompensation
    Heart failure decompensation sensor
    Device typeA subcutaneous or insertable cardiac monitoring technology
    Data usedUses multiparameter data such as heart-rate variability, activity, thoracic impedance, and respiration
    Clinical purposeEstimates short-term risk of heart-failure worsening