Anesthesia Services for Interventional Pain Management Procedures in an Adult - (0551)

Cigna covers moderate sedation and monitored anesthesia care (MAC) for adults (≥18) only for specified interventional pain procedures that require prolonged immobility/painful positioning—moderate sedation when immobility is required or for certain listed injections with severe anxiety under active management, and MAC when immobility is required or when the procedure plus ASA III+ or specified comorbidities are present; coverage excludes children <18, trigger point and peripheral joint injections, other nonlisted indications, and services without the policy’s listed CPT/ICD‑10 codes. Required documentation includes age, the specific procedure and CPT/HCPCS/ICD‑10 codes, objective justification (prolonged immobility or the listed comorbidity/ASA class or active treatment for severe anxiety), an anesthesia preprocedural assessment/plan for MAC, and objective evidence for any cited risk factors (e.g., BMI, eGFR, MELD, sleep apnea, substance use), otherwise claims will be denied.