Cigna · Linx · US health-plan appeal rights

Linx denied as experimental or investigational by Cigna?

Q: How long do I have to appeal a Cigna Linx denial?

Internal appeal window: Typically 180 days from the denial date. External review window: Typically 60–120 days after the final internal denial. The clock starts from the date on the denial letter.

An experimental denial requires the appeal to cite the FDA approval (if any), peer-reviewed phase III data, and the recognised specialty-society guideline that supports the treatment for your indication.

By Michael John Ryan, Founder & Privacy Officer, DenialHelp, LLC

Last reviewed 2026-05-09

Policy data current as of 2026-04-26

US health-plan appeal rights

Cite: Most US health plans have appeal rights under either the ACA, ERISA, or Medicare/Medicaid rules

Most US health plans are required by federal law to give you both an internal appeal (where the insurer reconsiders) and an external review (where an independent reviewer decides). The exact timelines and processes depend on what kind of plan you have — marketplace / employer group, self-funded, Medicare Advantage, or Medicaid MCO — but in every case there's a window after the denial during which you have the right to fight it.

Internal appeal window

Typically 180 days from the denial date

External review window

Typically 60–120 days after the final internal denial

What Cigna typically requires

Age >=18-21. Chronic GERD >=6 months. Abnormal pH study (DeMeester >14.72 or AET >6%). Hiatal hernia <3cm (some plans <5cm with concurrent crural repair per SAGES 2021). Normal esophageal motility on manometry. Partial response to PPI. BMI <35.

Source policy: Cigna LINX Magnetic Sphincter Augmentation Coverage Policy

What works in the appeal

FDA PMA P100049 since Mar 22, 2012 — NOT 510(k), NOT investigational. CPT 43284/43285 established. RESPECT NEJM 2013 + CALIBER. SAGES 2021 conditional recommendation. For hiatal hernia: SAGES 2021 supports up to ~5cm with concurrent crural repair. Submit pH-impedance + manometry confirming normal motility.

Next steps

Find the date on the denial letter — your appeal window starts there.
Read your plan's Summary of Benefits and Coverage (SBC) for the specific deadlines.
Request the insurer's claim file in writing — they must provide it.
Submit your appeal in writing with new clinical evidence and a physician statement.

Get the letter drafted

DenialHelp drafts your appeal in 5 minutes — $40 list price, $30 for your first letter (use code SEO25). We cite the federal regs and the specific clinical evidence your plan responds to. Your physician signs and sends.

Start my appeal — $30 with code SEO25 →

Related appeal guides

Other Cigna appeals

Other denial reasons for Cigna Linx

denied as not medically necessary denied for failing step therapy denied as non-formulary denied for missing prior authorization denied as not FDA-approved for this use

This guide describes general US federal appeal rights based on Most US health plans have appeal rights under either the ACA, ERISA, or Medicare/Medicaid rules. Your specific plan documents (Summary of Benefits and Coverage, Evidence of Coverage) override anything here. DenialHelp is not your lawyer and not your physician — we draft appeal letters that your physician signs. Outcomes depend on your insurer's decision and factors outside our control. Reviewed by Michael John Ryan on 2026-05-09. Editorial standards: denialhelp.com/authors.