Condition and Treatment Index
Select the treatment or condition for additional information about billing and related rules.
NOTE: For Self-insured claims, you must contact the employer or third-party administrator.
Conditions and Treatments
- Acupuncture
- Acute Cauda Equina Syndrome (CES)
- Ankle/Foot Surgery
- Antiepileptic drugs guideline for chronic pain
- AquaMED
- Artificial disc replacement (ADR)
- Autologous Blood/Platelet-rich Plasma Injections (Effective September 1, 2016.)
- Autologous chondrocyte implantation (ACI) (Effective August 1, 2016.)
- Autologous chondrocyte implantation (ACI) (through July 30, 2016.)
- Bariatric Surgery for Obesity
- Beryllium, diagnostic guideline
- Bloodborne pathogens
- Bone growth stimulators
- Bone morphogenic proteins (BMP) for lumbar fusion and nonunion fracture of long bones
- Botulinum toxin
- Brevio® Nerve Conduction Testing System
- Breast Cancer Screening in Special Populations, Appropriate Imaging for
- Bronchial Thermoplasty for Asthma (Effective September 1, 2016.)
- Cardiac Nuclear Imaging
- Cardiac stents
- Carpal Tunnel Syndrome (CTS)
- Carotid Artery Stenting (CAS)
- Catheter Ablation Procedures for Supraventricular Tachyarrhythmias (SVTA)
- Ctrac™ for CTS wrist splint
- Cervical Spinal Fusion for Degenerative Disc Disease
- Cervical spine MRI checklist
- Cervical traction devices
- Chronologically controlled developmental therapy (was Futures Unlimited)
- Cochlear Implants: Bilateral versus Unilateral
- Complex Regional Pain Syndrome (CRPS)
- Cryotherapy and Compression Devices for Home Use
- Depression, treatment-resistant
- Deep Brain Stimulation (DBS)
- Discography
- Dry needling
- Duragesic
- Dynamic Spinal Visualization
- Dynamic Offloading Braces for Complex Ankle Injury
- Ebola Virus Exposure and Disease Policy
- Electrical Stimulation for Chronic Wounds
- Electroconvulsive Therapy (ECT)
- Electrodiagnostic sensory nerve conduction threshold (sNCT)
- Electrodiagnostic Testing
- Elevated Vacuum Suspension System
- Epidural adhesiolysis
- Epidural spinal injections (ESI)
- ERMI flexionater and extensionater
- Extracorporeal Membrane Oxygenation Therapy (ECMO)
- Extracorporeal shockwave therapy (ESWT)
- Facet Neurotomy
- Fibromyalgia
- Femoroacetabular Impingement Syndrome (FAI), Hip Surgery for
- Functional neuroimaging for primary degenerative dementia or mild cognitive impairment
- Game Ready™ Accelerated Recovery System
- Headache MRI checklist
- Hepatitis
- Hip Resurfacing (HR)
- HIV
- Home Modification
- Hyaluronic Acid/Viscosupplementation
- Hyperbaric Oxygen Therapy (HBOT)
- IDET (Intradiscal heating)
- Implantable Drug Delivery Systems
- Influenza
- Injections, spinal
- Intensity Modulated Radiation Therapy (IMRT)
- Low level laser therapy
- Low Back Pain, Guideline for Hospitalization
- Lower extremity MRI checklist
- Lumbar Fusion (Arthrodesis)
- Lumbar Nerve Root , Single (Lumbar Laminectomy)
- Lumbar spine MRI checklist
- MedX lumbar extension machine
- Meniscal allograft transplantation (MAT) (Effective: August 1, 2016)
- Meniscal allograft transplantation (MAT) (through: July 30, 2016)
- Mental Health Services
- Microprocessor-controlled lower extremity prostheses
- Myoelectric upper limb prosthetic devices
- NC-stat® nerve conduction system-NeuroMetrix®
- Neuromuscular electrical stimulators (NMES)
- Needlestick
- Negative pressure wound therapy
- Novocure (Tumor Treating Fields)
- Opioids - Prescribing Opioids to Treat Pain in Injured Workers
- Osteochondral Allograft/Autograft Transplantation (OAT)
- Osteopenia/Osteoporosis, Screening & Monitoring Tests for
- Percutaneous Discectomy for Disc Herniation
- Percutaneous Neuromodulation Therapy for low back pain
- Porphyria
- Post Exposure Prophylaxis and Testing (PEP)
- Powered Traction Devices for Intervertebral Decompression
- Proton Beam Therapy (PBT)
- Proximal Median Nerve Entrapment (PMNE)
- Psychiatric Services
- Rabies
- Radial Nerve Entrapment: Diagnosis and Treatment
- repetitive Transcranial Magnetic Stimulation (rTMS)
- Rhinosinusitis, Imaging for
- Robotic Assisted Surgery (RAS)
- Sacroplasty
- Shoulder Conditions Diagnosis and Treatment Guideline
- Sleep Apnea
- Spinal Cord Stimulation
- Spinal Injections
- Standing, Weight-bearing, Positional & Upright™ MRI
- Stereotactic Radiation Surgery (SRS) and Stereotactic Body Radiation Therapy (SBRT)
- Testosterone Testing
- Thermal shrinkage for instability
- Tinnitus Retraining Therapy
- Thoracic Outlet Syndrome - Neurogenic
- Thoracic Outlet Syndrome - Vascular
- Thoracic Spine MRI Checklist
- Tobacco Cessation Treatment for Surgical Care
- Total Disc Arthroplasty (TDA)
- transcranial Direct Current Stimulation (tDCS)
- Transcutaneous, Interferential and Percutaneous Electrical Nerve Stimulators (TENS)
- Treatment-resistant Depression
- Tuberculosis
- Tympanostomy Tubes
- Ulnar Neuropathy at the Elbow (UNE) Diagnosis and Treatment
- UniSpacer
- Upper Endoscopy for Gastroesophogeal Reflux Disease (GERD) and Gastrointestinal Symptoms
- Upper extremity MRI checklist
- Vagal Nerve Stimulation (VNS)
- Vertebroplasty
- Vision Therapy
- Vitamin D testing
