DecisionHealth, DecisionHealth - 2026 Issue 5 (May)

Question & Answer: Anesthesia for patients with anxiety faces hurdles

Question: We keep getting medical necessity denials for monitored anesthesia care and deep sedation performed for facet joint radiofrequency ablation procedures. In particular, we can’t get paid when the patients have mental disorder diagnoses such as F41.8 (Other specified anxiety disorders) or F40.232 (Fear of other medical care). We’ve appealed, but the anesthesia services are still denied as medically unnecessary.

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