CMM-400: Anesthesia Services for Interventional Pain Procedures

MAC is medically necessary for specified interventional pain procedures (regional sympathetic blocks, medial branch RFA, discography, spinal cord stimulator trial/permanent implantation, vertebral augmentation, intrathecal drug-delivery implantation) or for patients with listed behavioral (behavioral health attestation required if citing severe anxiety/psychiatric/cognitive impairment), hyperkinetic movement, anatomic airway, or significant medical risk factors, provided there is a preoperative anesthesia evaluation, informed consent, continual capnography plus standard monitoring, a qualified CRNA/anesthesiologist prepared to convert to general anesthesia, supervised recovery by skilled nursing under CRNA/anesthesiologist oversight, and complete documentation. MAC for manipulation/closed spine procedures and CPT 00640 are experimental/unproven, only one anesthesia CPT code is allowed per date of service, and MAC is only considered after the primary interventional pain procedure is approved (or if it does not require prior authorization).