Manipulation Under Anesthesia – Commercial and Individual Exchange Medical Policyopen_in_new

UnitedHealthcare covers MUA only for knee arthrofibrosis after total knee arthroplasty, knee surgery, or fracture and for shoulder adhesive capsulitis, and considers MUA unproven/not medically necessary for all other joints/conditions (e.g., ankle, finger, hip, pelvis, spine, TMJ, toe, wrist), while excluding finger manipulation the day after Xiaflex® and routine closed fracture/dislocation reductions. Key requirements: shoulder MUA requires meeting InterQual® CP criteria and knee MUA requires documented arthrofibrosis (persistent restrictive scar tissue despite rehabilitation); listed procedure/diagnosis codes are for reference only.

"MUA is unproven and not medically necessary for all other conditions (whether for single or serial manipulations) including but not limited to the following due to insufficient evidence of efficacy..."

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