Manipulation Under Anesthesia Id Cs
UnitedHealthcare Community Plan medical policy for Manipulation Under Anesthesia applicable only to the state of Idaho (including Idaho Medicaid Plus plans). Defines medically necessary indications, not medically necessary uses, exclusions, applicable codes, clinical evidence summary, and related guidance.
Supporting Information: Updated Clinical Evidence and References sections to reflect the most current information.
Coverage Summary
This policy addresses Manipulation Under Anesthesia (MUA) for UnitedHealthcare Community Plan in Idaho, including Idaho Medicaid Plus (Policy #CS075ID.B). The policy status is CURRENT with an effective date of August 1, 2025 and last review date of August 1, 2025. The coverage stance is mixed: specific indications are covered when criteria are met while many other uses are considered not medically necessary due to insufficient evidence.