Archived Policies - Therapy
Manipulation of Spine Requiring Anesthesia, Any Region
The risks of manipulating a spine under anesthesia are considerable and the indications for this procedure under anesthesia are exceedingly rare. Based on lack of peer review literature in either the orthopedic or osteopathic journals, this procedure should be denied when used as a treatment for back pain. For treatment of a traumatic fracture and/or dislocation, CPT 22315 would be appropriate and all inclusive.
Coverage is not allowed for anesthesia related to this procedure.
Code 22505 relates to traumatic episodes involving major pathology of the spine rather than back pain. This is not designed as a chiropractic or osteopathic manipulative procedure but follows the fracture and/or dislocation series in the AMA, CPT book devoted to the spine and precedes the section on arthrodesis.
Each benefit plan, summary plan description or contract defines which services are covered, which services are excluded, and which services are subject to dollar caps or other limitations, conditions or exclusions. Members and their providers have the responsibility for consulting the member's benefit plan, summary plan description or contract to determine if there are any exclusions or other benefit limitations applicable to this service or supply. If there is a discrepancy between a Medical Policy and a member's benefit plan, summary plan description or contract, the benefit plan, summary plan description or contract will govern.
|Title:||Effective Date:||End Date:|
|Manipulation Under Anesthesia||06-15-2018||07-31-2019|
|Manipulation Under Anesthesia||12-01-2017||06-14-2018|
|Manipulation Under Anesthesia||09-01-2016||11-30-2017|
|Manipulation Under Anesthesia||06-15-2015||08-31-2016|
|Manipulation Under Anesthesia||07-01-2014||06-14-2015|
|Manipulation Under Anesthesia||01-15-2013||06-30-2014|
|Spinal Manipulation under Anesthesia||06-01-2008||01-14-2013|
|Spinal Manipulation under Anesthesia||04-01-2007||05-31-2008|
|Spinal Manipulation under Anesthesia||01-23-2004||03-31-2007|
|Manipulation of Spine Requiring Anesthesia, Any Region||05-01-1996||01-22-2004|