Transcription of 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 .. 9 References .. 9 Policy History/Revision Information .. 11 Instructions for Use .. 11 Coverage Rationale Manipulation Under Anesthesia (MUA) is proven and medically necessary for: Knee joint for Arthrofibrosis following total knee arthroplasty, knee surgery, or fracture 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
Manipulation under anesthesia (MUA) is a non -invasive procedure which combines manual manipulation of a joint or the spine with an anesthetic. Individuals who are unable to tolerate manual procedures due to pain, spasm, muscle contractures, or guarding may benefit from the use of an anesthetic agent prior to manipulation.
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