CG-MED-78 Anesthesia Services for Interventional Pain Management Procedures

This policy addresses anesthesia services, including monitored anesthesia care (MAC), for interventional pain management procedures (e.g., nerve blocks). Coverage is medically necessary when documentation shows the need for qualified anesthesia personnel in addition to the proceduralist and when the patient’s condition/procedure warrants MAC, such as ASA class ≥3 comorbidities (cardiac/pulmonary disease, BMI ≥40), obstructive sleep apnea, prior sedation complications, or severe anxiety/psychiatric/cognitive impairments affecting safety. Anesthesia services for these procedures are not medically necessary for all other indications.

"For interventional pain management procedures, including but not limited to nerve blocks, anesthesia services including monitored anesthesia care (MAC) are consideredmedically necessarywhen the fol..."

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