Meniscal Allograft Transplantation (MAT)

Coverage decision: Covered with Conditions

Medical treatment guidelines:Adobe PDFSurgical Guideline for Work-related Knee Injuries (Effective: August 1, 2016).

Meniscal allograft transplantation involves surgically replacing the meniscus with a properly sized donor graft.

Authorization requirements


Is authorization required?

How do I get pre-authorization?

Yes

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

For self-insured: Contact the employer or its third party administrator

Billing and payment policies

Regulatory authority and related information

 

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