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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
Acute Cauda Equina Syndrome (CES) (112 KB PDF) (Effective April 26, 2014)
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Ankle and Foot Surgical Guideline (740 KB PDF) (Effective October 1, 2017)
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Beryllium - Clinical Guideline for the Diagnosis of Beryllium Sensitization and Chronic Beryllium Disease (539 KB PDF).
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Carpal Tunnel Syndrome (CTS) Guideline (112 KB PDF)(Effective July 1, 2017)
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Cervical Radiculopathy and Myelopathy (28 KB PDF) (Effective December 1, 2014) (Modified June 3, 2016, to correct typo)
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Complex Regional Pain Syndrome (CRPS-2011) (373 KB PDF). (Effective October 1, 2011)
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Facet Neurotomy (778 KB PDF) (Effective October 1, 2014) (Revised October 2017)
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Knee Surgery (73 KB PDF) (Effective: August 1, 2016)
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Low Back Pain, Guideline for Hospitalization for (40 KB PDF)
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Lumbar Fusion Guideline (arthrodesis) (121 KB PDF) (Effective Date: March 7, 2016)
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Lumbar Nerve Root, Single (Lumbar Radiculopathy) (515 KB PDF) (Effective Date: November 1, 2018)
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Lumbar Nerve Root, Single (Lumbar Laminectomy) (20 KB PDF)
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Porphyria Conditions (53 KB PDF) (Re-posted January 2015)
- Prescribing Opioids to Treat Pain in Injured Workers (Effective July 1, 2013)
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Proximal Median Nerve Entrapment (PMNE) (150 KB PDF) (Updated August 1, 2014)
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Radial Nerve Entrapment: Diagnosis and Treatment (152 KB PDF) (Effective April 1, 2010)
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Sacroiliac - Interim Decision (471 KB PDF) (Effective June 2018)
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Shoulder Conditions Diagnosis and Treatment Guideline (1.06 MB PDF) (Effective May 1, 2018)
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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:
Simone Javaher, RN, BSN, MPA
Clinical Health Policy Manager
Email: Simone.Javaher@Lni.wa.gov
Phone: 360-902-4246.