Epidural Steroid Injection
To use the ESI criteria tool, visit the Medicalis website.
HealthPartners recognizes the value of prior notification/decision support for epidural steroid injections (ESI) for low back pain. In alignment with the Triple Aim, HealthPartners has established an ESI prior notification/decision support program with the following goals:
- Encourage a collaborative approach for patient care
- Explore conservative treatment options for chronic low back pain
- Provide clinicians with a tool to assess treatment options that support long-term functional improvement prior to ordering an injection
This prior notification/decision support tool has a strong foundation in ICSI guidelines that informs consistent evidence based decisions.
Providers are able to use one of the following types of prior notification/decision support tools:
- Web-based via Medicalis Consult Portal
- Electronic Medical Records integrated
When performing prior notification/decision support, ordering providers are required to submit the prior notification/decision support number (DSN) to the rendering provider for inclusion on the claim.
- Review the HealthPartners coverage criteria for coding descriptions
- Failure to use the prior notifcation/decision support tool may result in claim denial and reinstatement of the prior authorization requirement
For providers that use Medicalis as their web-based vendor, use the link to access the Consult Portal: https://consult.medicalis.com/.
If you do not use Medicalis and would like more information, contact Medicalis Support at 1-877-579-5454 (available 9:00AM-5:00PM EST).
Remember to verify the member's benefits and network with HealthPartners Member Services at (952)883-5000 or 1-800-883-2177.
Please be aware that other services performed in conjunction with an ESI may require prior authorization. Please verify the coverage criteria prior to providing the service.