Manipulation Under Anesthesia - UHCprovider.com

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Manipulation Under Anesthesia Page 1 of 11 UnitedHealthcare Commercial Medical Policy Effective 04/01/2021 Proprietary Information of UnitedHealthcare. Copyright 2021 United HealthCare Services, Inc. UnitedHealthcare Commercial Medica l Policy Manipulation Under Anesthesia Policy Number: 2021T0515T Effective Date: April 1, 2021 Instructions for Use Table of Contents Page Coverage Rationale ........................................ ............................... 1 Definitions ........................................ ........................................ ...... 1 Applicable Codes ........................................ .................................. 2 Description of Services ........................................ ......................... 5 Clinical Evidence ........................................ ................................... 5 Food and Drug Administration.

Shoulder joint for adhesive capsulitis (frozen shoulder) 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: Ankle Finger Hip joint or adhesive capsulitis of the hip

  Under, Shoulder, Adhesive, Anesthesia, Frozen, Manipulation, Frozen shoulder, Adhesive capsulitis, Capsulitis, Manipulation under anesthesia