Payer PolicyActive
CG-MED-65 Manipulation Under Anesthesia
ANTHEM-CG-MED-65
Anthem
Effective: October 1, 2025
Updated: December 30, 2025
Policy Summary
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.
Coverage Criteria Preview
Key requirements from the full policy
"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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