Manipulation Under General Anesthesia

Aetna covers MUA for knee arthrofibrosis after TKA, knee surgery, or fracture (CPT 27570) when ROM is <90° persisting 4–6 weeks up to 6 months post‑event with no progression/regression, for chronic refractory adhesive capsulitis of the shoulder (CPT 23700) when selection criteria are met, and for TMJ disorders. Spinal MUA (SMUA/CPT 22505) and MUA for cruciate ligament injuries, multiple joints, most other joints (e.g., ankle, elbow, finger, hip, pelvis, toe, wrist), osteoporotic thoracolumbar compression fractures, post‑Xiaflex Dupuytren’s hand/finger MUA, and several listed CPT codes are considered experimental/investigational and not covered.

"Manipulation under anesthesia, shoulder joint (CPT 23700) for adhesive capsulitis when selection criteria are met (see Appendix)."

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