Upper extremity MRI checklist

Authorization requirements


Is authorization required?

How do I get pre-authorization?

Yes

L&I (State fund):
Utilization Review provided by Qualis

Self-insured:
Contact the employer

Related information on coverage and treatment

L&I has prepared a checklist of coverage criteria for magnetic resonance imaging (MRI) of the upper extremity.

Billing and payment policies

Related rules

 

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