Limitations to Pain Management Services

Date Issued: 1/17/2014

Specific to epidural and facet injections, sedation and/or Monitored Anesthesia Care (MAC) services are not generally required for pain management procedures. Anesthesia services will be denied (unless substantiated as being medically necessary) when reported with a pain management service. Modifier 59 will not override this edit.

For more information, please go to our Medical Policies, Pain Management section of Clinical Corner.