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For Medical Providers

Myoelectric upper limb prosthetic devices

Myoelectric prostheses for the upper limbs are a covered benefit with conditions.

Authorization requirements

Is authorization required?	How do I get pre-authorization?
Yes	L&I (State fund): Contact the claim manager By phone: To get the claim manager’s phone number, call the Claim Information line (1-800-831-5227) By secure email: If you are the attending physician, IME, or concurrent care provider, log into to the Claims & Account Center (CAC)	Self-insured: Contact the employer

Related information on coverage and treatment

Coverage decision: Myoelectric upper limb prosthetic devices (Effective Date: January 1, 2014).

Billing and payment policies

Durable Medical Equipment.

Related rules

Treatment requiring authorization. WAC 296-20-03001.
Medical coverage decisions. WAC 296-20-02700-02850.

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