Anesthesia and Facility Services for Dental Treatment - (0415)

Cigna covers monitored anesthesia care/general anesthesia and associated facility charges for dental procedures only when specific patient- or procedure-based criteria are met (e.g., age ≤7, inability to use local anesthesia, severe psychological/developmental disability, ASA III+ or significant comorbidities, or listed complex procedures such as multiple extractions, impacted third molars, implants); anesthesia for cosmetic dental/oral surgery and services not meeting criteria are excluded. Coverage requires appropriately trained/licensed personnel to administer and monitor anesthesia in a properly equipped office or accredited hospital/ASC and thorough documentation (preop H&P and labs as needed, ASA and airway assessment, justification that conscious/local anesthesia is inadequate, provider qualifications, facility safety/emergency preparedness, and discharge criteria).

"MAC/general anesthesia and associated facility charges in conjunction with dental surgery or procedures performed by a dentist, oral surgeon, or oral maxillofacial surgeon are considered medically ..."