Epidural Steroid Injection

To use the ESI criteria tool, visit the Medicalis website.

Program Summary

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
  • Build-you-own

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.

Additional details

  • 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.

For questions on Prior Notification/Decision Support:

Please email us at: ESI@HealthPartners.com.