Medical Treatment Guidelines
The medical treatment guidelines are written from a clinical perspective, to guide clinical care. Providers should consult the Medical Aid Rules and Fee Schedule (MARFS) for documentation and coding requirements.
The Medical Treatment Guidelines (also called Medical Practice Guidelines or Review Criteria) are evidence based and were developed by the Office of the Medical Director in collaboration with practicing physicians and advisors.
Some guidelines are intended to be educational tools for medical providers. Some guidelines and the review criteria are used by L&I in the Utilization Review program and claim management process to promote best practices and improve the health of injured workers. They are published by L&I, which is solely responsible for coverage decisions that may result from their use.
How to use the guidelines
Health care providers are expected to be familiar with the guidelines and follow the recommendations. Good medical judgment is important in deciding how to use and interpret this information.
Guideline history and development process
See the Guideline Process for background information and a description of how guidelines are prioritized, developed, and implemented. All current guidelines are those listed individually below.
Medical Treatment Guidelines
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Acute Cauda Equina Syndrome (CES) (112 KB PDF). (Effective April 26, 2014) -
Ankle/Foot Surgery (31 KB PDF).
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Antiepileptic drugs guideline for chronic pain (22 KB PDF). (Effective August 1, 2005)
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Carpal Tunnel Syndrome (CTS) Guideline (407 KB PDF). (Updated - Effective February 6, 2014)
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Cervical Nerve Root, Single (28 KB PDF).
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Complex Regional Pain Syndrome (CRPS-2011) (373 KB PDF). (Effective October 1, 2011)
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Facet Neurotomy (73 KB PDF).
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Knee Surgery (73 KB PDF).
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Low Back Pain, Guideline for Hospitalization for (40 KB PDF).
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Lumbar Fusion, Guidelines for (Arthrodesis) (36 KB PDF). (Effective November 1, 2009)
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Lumbar Nerve Root, Single (Lumbar Laminectomy) (20 KB PDF).
- Prescribing Opioids to Treat Pain in Injured Workers (Effective July 1, 2013)
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Proximal Median Nerve Entrapment (PMNE) (150 KB PDF).(Effective August 1, 2009)
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Psychiatric Conditions (53 KB PDF).
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Radial Nerve Entrapment: Diagnosis and Treatment (152 KB PDF). (Effective April 1, 2010)
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Shoulder Conditions Diagnosis and Treatment Guideline (823 KB PDF). (Effective October 24, 2013)
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Thoracic Outlet Syndrome - Neurogenic (204 KB PDF). (Effective October 1, 2010)
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Thoracic Outlet Syndrome - Vascular (26 KB PDF).
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Ulnar Neuropathy at the Elbow (UNE) Diagnosis and Treatment (167 KB PDF). (Effective January 1, 2010)
For questions about these guidelines or the guideline development process, please contact:
Teresa Cooper, ONC
Email: Teresa.Cooper@Lni.wa.gov
Phone: 360-902-5762.