For dates of service on or after April 11, 2022, general anesthesia (GA) or monitored anesthesia care (MAC) services for epidural, paravertebral facet, and sacroiliac joint injections for spinal pain management are considered not medically necessary for most Independence Commercial and Medicare Advantage HMO and PPO members, and Independence Administrators members. Detailed information is available in the following policies:
Coverage may be considered when GA or MAC services for these injections are requested based on an individual's unique clinical circumstances. In these instances, if approved, providers must report CPT® codes 01991 and 01992.
Additional changes
Effective April 11, 2022, Independence updated Medical Policy, #11.15.23k: Epidural, Paravertebral Facet, and Sacroiliac Joint Injections for Spinal Pain Management to remove language on anesthesia. This change affects Independence Administrators members only. The new policy, #01.00.12: Anesthesia Services for Epidural, Paravertebral Facet and Sacroiliac Joint Injections for Spinal Joint Management, is in effect for all Independence Administrators for dates of service on or after April 11, 2022.
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