DPPO Clinical Coverage Determination Guidelines updates are now available!

August 14, 2024

Information about the Cigna Dental Clinical Coverage Determination Guidelines relied upon in making benefit determinations is available immediately at CignaforHCP.com > Resources > Reference Guides.

The latest updated version of the DPPO document is now available. 

Updates include the following: 

  1. Addition of policy REST-01 for existing direct restorations guidelines.
  2. Updates to include existing frequency limitations to the following policies:
  • PERIO-01
  • PERIO-03
  • PERIO-04
  • PERIO-05
  • PERIO-06
  • PERIO-07
  • PERIO-08
  • PERIO-09
  • PERIO-10
  • PERIO-11
  • PERIO-13
  • PERIO-14
  • PERIO-15
  • PERIO-16
  • PERIO-19

You may also request this information by contacting Customer Service at 800.Cigna24 (800.244.6224). A copy will be provided to you or your authorized representative free of charge or you can reference the document in our resources section, located at the bottom of this web page.

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