Manipulation Under Anesthesia

This policy addresses manipulation under anesthesia (MUA) — brief (≈15–20 minute) spinal and joint manipulative procedures performed while the patient is anesthetized — for conditions such as chronic spinal (cranial/cervical/thoracic/lumbar), sacroiliac and pelvic pain, certain isolated joint problems (e.g., arthrofibrosis), and selected post‑injection/post‑epidural scenarios; Illinois law also mandates related therapy/equipment coverage for children with specified neuromuscular or neurological impairments. Many MUA applications (including spinal manipulation under joint anesthesia, serial or multiple‑joint sessions, and several post‑injection approaches) are considered experimental/investigational and not covered; coverage depends on the member’s benefit plan and state law, typically requires prior failure of conservative care, limited supporting evidence and reported serious adverse events, and adequate follow‑up (generally ≥6 months) to demonstrate efficacy.