CommercialCoverageMedium impact
Manipulation Under Anesthesia
Blue Cross & Blue Shield of Mississippi·MS · Orthopedics, Anesthesiology, Pain Management +2 more·Medical Policy
We identified it
Jun 20, 2026
Summary
This BCBS policy classifies manipulation under anesthesia (MUA) for chronic spinal, sacroiliac, and pelvic pain as investigational and non-covered. The policy specifically excludes coverage for CPT codes 00640 and 22505 for chronic pain conditions, though MUA remains covered for acute conditions like fractures and adhesive capsulitis.
Action Required
Immediately: Billing team must verify that CPT codes 00640 (anesthesia for spinal manipulation) and 22505 (manipulation of spine requiring anesthesia) are flagged as non-covered for chronic pain conditions in BCBS plans. Ensure claims for these codes include proper documentation distinguishing acute conditions (fractures, dislocations, adhesive capsulitis) from chronic pain to avoid denials. Update encounter forms to alert providers that MUA for chronic spinal/pelvic pain is investigational and not covered.