CG-MED-65 Manipulation Under Anesthesia

This policy addresses manipulation under anesthesia (MUA), primarily of the spine. Spine MUA is covered only to treat vertebral fracture, complete dislocation, or acute traumatic incomplete dislocation (subluxation). It is not covered for any other spinal indications, and MUA of other joints is not covered except for the knee or shoulder.

"Manipulation under anesthesia of the spine is consideredmedically necessaryfor the treatment of vertebral fracture, complete dislocation of the spine, or acute traumatic incomplete dislocation (sub..."

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