For Medical Providers

Myoelectric upper limb prosthetic devices

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

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

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