TFESI — Lumbar/Sacral (1st level) at Cigna.
How Cigna approaches CPT 64483 (TFESI — Lumbar/Sacral (1st level)) for prior-authorization review: at last review on 2026-05-11, the policy covers this code with prior authorization required.
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CMM-200Verification pending. This record is awaiting confirmation against the latest policy document — criteria summary may not reflect the current revision.
Criteria summary
High-level themes from the Cigna policy of record for CPT 64483. Verbatim policy text and per-criterion analysis are available after sign-in.
- At least 6 weeks of conservative care typically required.
- Imaging concordance documentation required.
Source: Cigna CMM-200 (eviCore CMM) — Epidural Steroid Injections
See the full Cigna criteria.
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