CMM-400: Anesthesia Services for Interventional Pain Procedures

MAC is covered for specified interventional pain procedures (regional sympathetic blocks; medial branch radiofrequency ablation; discography; spinal cord stimulator trial/permanent implantation; vertebral augmentation; intrathecal drug delivery implantation) or when specific patient risk factors exist (severe anxiety with behavioral-health attestation, hyperkinetic movement disorders, airway/anatomic risks, or significant comorbidities), while MAC for manipulation/closed procedures of the spine (CPT 00640) is considered experimental/unproven and excluded. Coverage requires documented preoperative anesthesia evaluation including airway exam, informed consent with alternative sedation discussion (and behavioral-health attestation if applicable), continual capnography, administration by a CRNA or anesthesiologist prepared to rescue the airway/convert to general anesthesia, qualified personnel to manage airway complications, supervised recovery by skilled nursing under CRNA/anesthesiologist oversight, and that the interventional procedure is approved or not subject to prior authorization.