© Copyright 2025 American Medical Association. All rights reserved.
Manipulation under anesthesia (MUA) is a specialized procedure that involves the manual manipulation of the spine while the patient is under the influence of anesthesia, which can be either general anesthesia or conscious sedation. This technique is particularly beneficial for patients who are unable to tolerate traditional manual manipulation due to various factors such as significant pain response, muscle spasms, contractures, or guarding reflexes. The primary goal of MUA is to facilitate spinal manipulation in a controlled environment, allowing the physician to perform necessary adjustments without causing undue discomfort to the patient. During the procedure, the physician employs a series of specific short-level arm manipulations, passive stretching techniques, and targeted articular and postural kinesthetic integrations. These methods are designed to achieve a desired therapeutic outcome, which may include improved mobility, reduced pain, and enhanced overall function. Following the MUA procedure, patients typically engage in daily rehabilitation to support recovery and maximize the benefits of the manipulation performed.
© Copyright 2025 Coding Ahead. All rights reserved.
Manipulation under anesthesia (MUA) is indicated for patients who present with conditions that significantly limit their ability to undergo manual manipulation due to pain or muscle tension. The following are specific indications for this procedure:
The procedure of manipulation under anesthesia (MUA) involves several critical steps to ensure safety and effectiveness. Each step is designed to facilitate the manipulation of the spine while minimizing discomfort for the patient.
Following the manipulation under anesthesia (MUA) procedure, patients are typically advised to engage in daily rehabilitation to support their recovery. This rehabilitation may include physical therapy exercises aimed at improving mobility, strength, and overall function. Patients are also monitored for any post-procedure discomfort or complications, and follow-up appointments may be scheduled to assess progress and make any necessary adjustments to the treatment plan. It is important for patients to adhere to the rehabilitation program and any additional care instructions provided by their healthcare provider to maximize the benefits of the MUA procedure.
| Short Descr | MANIPULATION OF SPINE | Medium Descr | MANIPULATION SPINE REQUIRING ANESTHESIA | Long Descr | Manipulation of spine requiring anesthesia, any region | Status Code | Active Code | Global Days | 010 - Minor Procedure | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 1 - Statutory payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Hospital Part B services paid through a comprehensive APC | ASC Payment Indicator | Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P5B - Ambulatory procedures - musculoskeletal | MUE | 1 | CCS Clinical Classification | 9 - Other OR therapeutic nervous system procedures |
| SG | Ambulatory surgical center (asc) facility service | 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | AG | Primary physician | LT | Left side (used to identify procedures performed on the left side of the body) | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
|
Date
|
Action
|
Notes
|
|---|---|---|
| Pre-1990 | Added | Code added. |
Get instant expert-level medical coding assistance.