Manipulation Under Anesthesia (MUA)
Defines coverage stance for manipulation under anesthesia (spinal and other joints) for Medicare Advantage and commercial products, including indications considered not medically necessary and limited situations considered medically necessary (isolated joint conditions, fractures, dislocations, adhesive capsulitis, post-replacement fibrosis). Prior authorization and specific medical criteria sections state 'Not applicable.'
No material clinical or coverage changes in this policy update.
Coverage Summary
Defines coverage stance for Manipulation Under Anesthesia (MUA) for Medicare Advantage and commercial products. The policy takes a mixed coverage stance: it specifies limited medically necessary indications for isolated joint conditions (e.g., arthrofibrosis, adhesive capsulitis), fractures, dislocations, and post–total joint replacement fibrosis, while deeming MUA for certain chronic pain uses and broader applications as not covered or not medically necessary. Effective date: 2024-05-01. Last review: 2024-04-17.