Clinical Guidelines
This Clinical Guideline has been developed in accord with medical necessity criteria contained in Hawaii's Patients' Bill of Rights and Responsibilities Act (Hawaii Revised Statutes §432E-1.4), generally accepted standards of medical practice. If a treating physician disagrees with NIA's determination as to medical necessity in a given case, the physician may request that HMSA reconsider the application of the medical necessity criteria to the case at issue in light of any supporting documentation.
Physical Medicine Solutions
Click
here
to view NIA’s Physical Medicine guidelines.
Magellan adopted the use of
MCG Guidelines®
for its Physical Medicine product. View
instructions
for accessing MCG Guidelines®.
Medicaid Solutions
Magellan adopted the use of
MCG Guidelines®
for Ohio Medicaid members. View
instructions
for accessing MCG Guidelines®.
Medicare Solutions
NIA uses the
Local Coverage Determinations (LCD) and National Coverage Determinations (NCD)
directly from CMS
Place of Service
Please refer to Total Hip Arthroplasty/Resurfacing or Total Knee Arthroplasty (TKA) for details.
Please select a Health Plan
