# Mid and Low Back Injury Aggregated by Superinsight from public-domain sources, as of 2026-10-05. Domain: wc/ny. --- ## Mid and Low Back Injury MTG § A.1 — Medical Care {#a.1} *NY WCB Mid and Low Back Injury MTG, 4th ed., § A.1* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ A.1 — Medical Care** · page 6 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § A.2 — Rendering Of Medical Services {#a.2} *NY WCB Mid and Low Back Injury MTG, 4th ed., § A.2* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ A.2 — Rendering Of Medical Services** · page 6 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § A.3 — Positive Patient Response {#a.3} *NY WCB Mid and Low Back Injury MTG, 4th ed., § A.3* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ A.3 — Positive Patient Response** · page 6 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § A.4 — Re-Evaluate Treatment {#a.4} *NY WCB Mid and Low Back Injury MTG, 4th ed., § A.4* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ A.4 — Re-Evaluate Treatment** · page 6 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § A.5 — Education {#a.5} *NY WCB Mid and Low Back Injury MTG, 4th ed., § A.5* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ A.5 — Education** · pages 6–7 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § A.6 — Acuity {#a.6} *NY WCB Mid and Low Back Injury MTG, 4th ed., § A.6* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ A.6 — Acuity** · page 7 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § A.7 — Initial Evaluation {#a.7} *NY WCB Mid and Low Back Injury MTG, 4th ed., § A.7* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ A.7 — Initial Evaluation** · page 7 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § A.8 — Diagnostic Time Frames {#a.8} *NY WCB Mid and Low Back Injury MTG, 4th ed., § A.8* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ A.8 — Diagnostic Time Frames** · page 7 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § A.9 — Treatment Time Frames {#a.9} *NY WCB Mid and Low Back Injury MTG, 4th ed., § A.9* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ A.9 — Treatment Time Frames** · page 7 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § A.10 — Delayed Recovery {#a.10} *NY WCB Mid and Low Back Injury MTG, 4th ed., § A.10* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ A.10 — Delayed Recovery** · pages 7–8 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § A.11 — Active Interventions {#a.11} *NY WCB Mid and Low Back Injury MTG, 4th ed., § A.11* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ A.11 — Active Interventions** · page 8 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § A.12 — Active Therapeutic Exercise Program {#a.12} *NY WCB Mid and Low Back Injury MTG, 4th ed., § A.12* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ A.12 — Active Therapeutic Exercise Program** · page 8 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § A.13 — Diagnostic Imaging And Testing Procedures {#a.13} *NY WCB Mid and Low Back Injury MTG, 4th ed., § A.13* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ A.13 — Diagnostic Imaging And Testing Procedures** · pages 8–9 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § A.14 — Surgical Interventions {#a.14} *NY WCB Mid and Low Back Injury MTG, 4th ed., § A.14* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ A.14 — Surgical Interventions** · page 9 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § A.15 — Pre-Authorization {#a.15} *NY WCB Mid and Low Back Injury MTG, 4th ed., § A.15* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ A.15 — Pre-Authorization** · page 9 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § A.16 — Psychological/Psychiatric Evaluations {#a.16} *NY WCB Mid and Low Back Injury MTG, 4th ed., § A.16* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ A.16 — Psychological/Psychiatric Evaluations** · pages 9–10 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § A.17 — Personality/Psychological/Psychosocial Intervention {#a.17} *NY WCB Mid and Low Back Injury MTG, 4th ed., § A.17* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ A.17 — Personality/Psychological/Psychosocial Intervention** · page 10 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § A.18 — Functional Capacity Evaluation (FCE) {#a.18} *NY WCB Mid and Low Back Injury MTG, 4th ed., § A.18* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ A.18 — Functional Capacity Evaluation (FCE)** · pages 10–11 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § A.19 — Return To Work {#a.19} *NY WCB Mid and Low Back Injury MTG, 4th ed., § A.19* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ A.19 — Return To Work** · page 11 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § A.20 — Job Site Evaluation {#a.20} *NY WCB Mid and Low Back Injury MTG, 4th ed., § A.20* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ A.20 — Job Site Evaluation** · pages 11–12 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § A.21 — Guideline Recommendations And Medical Evidence {#a.21} *NY WCB Mid and Low Back Injury MTG, 4th ed., § A.21* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ A.21 — Guideline Recommendations And Medical Evidence** · page 12 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § A.22 — Experimental/Investigational Treatment {#a.22} *NY WCB Mid and Low Back Injury MTG, 4th ed., § A.22* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ A.22 — Experimental/Investigational Treatment** · page 12 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § A.23 — Injured Workers As Patients {#a.23} *NY WCB Mid and Low Back Injury MTG, 4th ed., § A.23* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ A.23 — Injured Workers As Patients** · page 12 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § A.24 — Scope of Practice {#a.24} *NY WCB Mid and Low Back Injury MTG, 4th ed., § A.24* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ A.24 — Scope of Practice** · pages 12–13 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § B.1 — History Taking and Physical Examination {#b.1} *NY WCB Mid and Low Back Injury MTG, 4th ed., § B.1* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ B.1 — History Taking and Physical Examination** · page 13 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § B.1.a.i — Mechanism of Injury: This includes details of symptom onset {#b.1.a.i} *NY WCB Mid and Low Back Injury MTG, 4th ed., § B.1.a.i* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ B.1.a.i — Mechanism of Injury: This includes details of symptom onset** · page 13 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § B.1.a.ii — Location of pain, nature of symptoms, and alleviating/ {#b.1.a.ii} *NY WCB Mid and Low Back Injury MTG, 4th ed., § B.1.a.ii* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ B.1.a.ii — Location of pain, nature of symptoms, and alleviating/** · page 13 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § B.1.a.iii — The use of an accepted pain assessment tool, (e.g. the Visual Analog Scale [VAS]) is highly recommended, especially during {#b.1.a.iii} *NY WCB Mid and Low Back Injury MTG, 4th ed., § B.1.a.iii* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ B.1.a.iii — The use of an accepted pain assessment tool, (e.g. the Visual Analog Scale [VAS]) is highly recommended, especially during** · page 13 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § B.1.a.iv — Presence and distribution of lower extremity numbness, {#b.1.a.iv} *NY WCB Mid and Low Back Injury MTG, 4th ed., § B.1.a.iv* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ B.1.a.iv — Presence and distribution of lower extremity numbness,** · page 13 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § B.1.a.vi — Prior occupational and non-occupational injuries to the same {#b.1.a.vi} *NY WCB Mid and Low Back Injury MTG, 4th ed., § B.1.a.vi* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ B.1.a.vi — Prior occupational and non-occupational injuries to the same** · pages 13–14 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § B.1.c.viii — Sensory and motor examination of the lower extremities with specific nerve root focus. {#b.1.c.viii} *NY WCB Mid and Low Back Injury MTG, 4th ed., § B.1.c.viii* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ B.1.c.viii — Sensory and motor examination of the lower extremities with specific nerve root focus.** · page 15 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § B.1.c.x — If applicable, abdominal examination, , circumferential lower {#b.1.c.x} *NY WCB Mid and Low Back Injury MTG, 4th ed., § B.1.c.x* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ B.1.c.x — If applicable, abdominal examination, , circumferential lower** · page 15 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § B.1.c.xii — Lower extremity vascular exam to include palpation of distal {#b.1.c.xii} *NY WCB Mid and Low Back Injury MTG, 4th ed., § B.1.c.xii* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ B.1.c.xii — Lower extremity vascular exam to include palpation of distal** · page 15 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § B.1.d — Spinal Cord Evaluation {#b.1.d} *NY WCB Mid and Low Back Injury MTG, 4th ed., § B.1.d* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ B.1.d — Spinal Cord Evaluation** · page 15 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § B.1.d.i — Sharp and light touch, deep pressure, temperature and proprioceptive sensory function; {#b.1.d.i} *NY WCB Mid and Low Back Injury MTG, 4th ed., § B.1.d.i* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ B.1.d.i — Sharp and light touch, deep pressure, temperature and proprioceptive sensory function;** · page 15 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § B.1.d.v — Spinal cord lesions should be classified according to the American Spine Injury Association (ASIA) impairment scale. {#b.1.d.v} *NY WCB Mid and Low Back Injury MTG, 4th ed., § B.1.d.v* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ B.1.d.v — Spinal cord lesions should be classified according to the American Spine Injury Association (ASIA) impairment scale.** · page 15 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § B.1.e — Red Flags {#b.1.e} *NY WCB Mid and Low Back Injury MTG, 4th ed., § B.1.e* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ B.1.e — Red Flags** · page 16 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § B.2 — Imaging / Anatomical Tests {#b.2} *NY WCB Mid and Low Back Injury MTG, 4th ed., § B.2* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ B.2 — Imaging / Anatomical Tests** · page 16 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § B.3 — Laboratory Testing {#b.3} *NY WCB Mid and Low Back Injury MTG, 4th ed., § B.3* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ B.3 — Laboratory Testing** · page 17 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § B.3.i — Complete blood count (CBC) with differential {#b.3.i} *NY WCB Mid and Low Back Injury MTG, 4th ed., § B.3.i* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ B.3.i — Complete blood count (CBC) with differential** · page 17 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § B.3.ii — Erythrocyte sedimentation rate (ESR), rheumatoid factor (RF), anti- {#b.3.ii} *NY WCB Mid and Low Back Injury MTG, 4th ed., § B.3.ii* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ B.3.ii — Erythrocyte sedimentation rate (ESR), rheumatoid factor (RF), anti-** · page 17 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § B.3.iii — Serum calcium, phosphorous, uric acid, alkaline phosphatase, and acid phosphatase {#b.3.iii} *NY WCB Mid and Low Back Injury MTG, 4th ed., § B.3.iii* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ B.3.iii — Serum calcium, phosphorous, uric acid, alkaline phosphatase, and acid phosphatase** · page 17 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § B.3.iv — Liver and kidney function {#b.3.iv} *NY WCB Mid and Low Back Injury MTG, 4th ed., § B.3.iv* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ B.3.iv — Liver and kidney function** · page 17 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § B.3.v — Serum Protein Electrophoresis {#b.3.v} *NY WCB Mid and Low Back Injury MTG, 4th ed., § B.3.v* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ B.3.v — Serum Protein Electrophoresis** · page 17 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § B.4 — Follow-Up Diagnostic Imaging and Testing Procedures {#b.4} *NY WCB Mid and Low Back Injury MTG, 4th ed., § B.4* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ B.4 — Follow-Up Diagnostic Imaging and Testing Procedures** · pages 17–18 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § C.1.a.i — Routine x-rays for acute non-specific back pain. {#c.1.a.i} *NY WCB Mid and Low Back Injury MTG, 4th ed., § C.1.a.i* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ C.1.a.i — Routine x-rays for acute non-specific back pain.** · pages 18–19 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § C.1.a.ii — Flexion and Extension Views {#c.1.a.ii} *NY WCB Mid and Low Back Injury MTG, 4th ed., § C.1.a.ii* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ C.1.a.ii — Flexion and Extension Views** · page 19 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § C.1.b — Magnetic Resonance Imaging (MRI) {#c.1.b} *NY WCB Mid and Low Back Injury MTG, 4th ed., § C.1.b* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ C.1.b — Magnetic Resonance Imaging (MRI)** · pages 19–20 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § C.1.b.i — Recommended - for patients with acute back pain during the first {#c.1.b.i} *NY WCB Mid and Low Back Injury MTG, 4th ed., § C.1.b.i* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ C.1.b.i — Recommended - for patients with acute back pain during the first** · page 20 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § C.1.b.ii — Recommended - for acute radicular pain syndromes in the first {#c.1.b.ii} *NY WCB Mid and Low Back Injury MTG, 4th ed., § C.1.b.ii* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ C.1.b.ii — Recommended - for acute radicular pain syndromes in the first** · page 20 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § C.1.b.iii — Recommended - for patients with non-acute radicular pain {#c.1.b.iii} *NY WCB Mid and Low Back Injury MTG, 4th ed., § C.1.b.iii* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ C.1.b.iii — Recommended - for patients with non-acute radicular pain** · page 20 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § C.1.b.iv — In cases where an epidural glucocorticosteroid injection is being {#c.1.b.iv} *NY WCB Mid and Low Back Injury MTG, 4th ed., § C.1.b.iv* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ C.1.b.iv — In cases where an epidural glucocorticosteroid injection is being** · page 20 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § C.1.b.v — Recommended - as an option for the evaluation of select non- {#c.1.b.v} *NY WCB Mid and Low Back Injury MTG, 4th ed., § C.1.b.v* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ C.1.b.v — Recommended - as an option for the evaluation of select non-** · page 20 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § C.1.b.vi — Not Recommended - for acute back pain or acute radicular pain {#c.1.b.vi} *NY WCB Mid and Low Back Injury MTG, 4th ed., § C.1.b.vi* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ C.1.b.vi — Not Recommended - for acute back pain or acute radicular pain** · page 20 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § C.1.b.vii — Not Recommended - standing or weight-bearing MRI is not {#c.1.b.vii} *NY WCB Mid and Low Back Injury MTG, 4th ed., § C.1.b.vii* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ C.1.b.vii — Not Recommended - standing or weight-bearing MRI is not** · page 20 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § C.1.c — Computerized Tomography (CT) {#c.1.c} *NY WCB Mid and Low Back Injury MTG, 4th ed., § C.1.c* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ C.1.c — Computerized Tomography (CT)** · page 21 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § C.1.c.i — Recommended - CT is recommended in select patients (MRI preferred) for those with radicular pain syndrome that has failed {#c.1.c.i} *NY WCB Mid and Low Back Injury MTG, 4th ed., § C.1.c.i* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ C.1.c.i — Recommended - CT is recommended in select patients (MRI preferred) for those with radicular pain syndrome that has failed** · page 21 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § C.1.c.ii — Recommended - in patients with an indication for MRI who {#c.1.c.ii} *NY WCB Mid and Low Back Injury MTG, 4th ed., § C.1.c.ii* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ C.1.c.ii — Recommended - in patients with an indication for MRI who** · page 21 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § C.1.c.iii — Not Recommended - routine CT for acute or non-acute non- {#c.1.c.iii} *NY WCB Mid and Low Back Injury MTG, 4th ed., § C.1.c.iii* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ C.1.c.iii — Not Recommended - routine CT for acute or non-acute non-** · page 21 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § C.1.d — Myelography (Including CT Myelography and MRI Myelography) {#c.1.d} *NY WCB Mid and Low Back Injury MTG, 4th ed., § C.1.d* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ C.1.d — Myelography (Including CT Myelography and MRI Myelography)** · page 21 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § C.1.d.i — Recommended - Myelography, including CT myelography, is {#c.1.d.i} *NY WCB Mid and Low Back Injury MTG, 4th ed., § C.1.d.i* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ C.1.d.i — Recommended - Myelography, including CT myelography, is** · page 21 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § C.1.d.ii — Not Recommended - Myelography (as well as CT myelography and MRI myelography) as the first diagnostic study for the {#c.1.d.ii} *NY WCB Mid and Low Back Injury MTG, 4th ed., § C.1.d.ii* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ C.1.d.ii — Not Recommended - Myelography (as well as CT myelography and MRI myelography) as the first diagnostic study for the** · page 22 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § C.1.e.i — Recommended - in select patients as clinically indicated. {#c.1.e.i} *NY WCB Mid and Low Back Injury MTG, 4th ed., § C.1.e.i* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ C.1.e.i — Recommended - in select patients as clinically indicated.** · page 22 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § C.1.e.ii — Not Recommended - for routine use in back pain patients. {#c.1.e.ii} *NY WCB Mid and Low Back Injury MTG, 4th ed., § C.1.e.ii* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ C.1.e.ii — Not Recommended - for routine use in back pain patients.** · page 22 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § C.1.f.i — Not Recommended - for the evaluation of acute or non-acute {#c.1.f.i} *NY WCB Mid and Low Back Injury MTG, 4th ed., § C.1.f.i* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ C.1.f.i — Not Recommended - for the evaluation of acute or non-acute** · page 22 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § C.1.g.i — Recommended - in select patients as clinically indicated. {#c.1.g.i} *NY WCB Mid and Low Back Injury MTG, 4th ed., § C.1.g.i* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ C.1.g.i — Recommended - in select patients as clinically indicated.** · page 22 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § C.1.i.i — Not Recommended - for the assessment of acute or non-acute {#c.1.i.i} *NY WCB Mid and Low Back Injury MTG, 4th ed., § C.1.i.i* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ C.1.i.i — Not Recommended - for the assessment of acute or non-acute** · page 22 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § C.2.a — Electrodiagnostic Studies (EDX) {#c.2.a} *NY WCB Mid and Low Back Injury MTG, 4th ed., § C.2.a* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ C.2.a — Electrodiagnostic Studies (EDX)** · page 23 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § C.2.a.i — EDX (must include needle EMG and NCV) {#c.2.a.i} *NY WCB Mid and Low Back Injury MTG, 4th ed., § C.2.a.i* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ C.2.a.i — EDX (must include needle EMG and NCV)** · page 23 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § C.2.b — Surface Electromyography (Surface EMG) {#c.2.b} *NY WCB Mid and Low Back Injury MTG, 4th ed., § C.2.b* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ C.2.b — Surface Electromyography (Surface EMG)** · page 23 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § C.2.c — Diagnostic Facet Blocks {#c.2.c} *NY WCB Mid and Low Back Injury MTG, 4th ed., § C.2.c* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ C.2.c — Diagnostic Facet Blocks** · page 24 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § C.2.d — Lumbar Discography {#c.2.d} *NY WCB Mid and Low Back Injury MTG, 4th ed., § C.2.d* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ C.2.d — Lumbar Discography** · page 24 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § C.2.e — CT/MRI Discography {#c.2.e} *NY WCB Mid and Low Back Injury MTG, 4th ed., § C.2.e* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ C.2.e — CT/MRI Discography** · page 24 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § C.2.f — Myeloscopy {#c.2.f} *NY WCB Mid and Low Back Injury MTG, 4th ed., § C.2.f* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ C.2.f — Myeloscopy** · page 24 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § C.2.g — Thermography {#c.2.g} *NY WCB Mid and Low Back Injury MTG, 4th ed., § C.2.g* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ C.2.g — Thermography** · pages 24–25 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § D.1 — Acupuncture {#d.1} *NY WCB Mid and Low Back Injury MTG, 4th ed., § D.1* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ D.1 — Acupuncture** · page 25 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § D.2.a — Shoe Insoles and Shoe Lifts {#d.2.a} *NY WCB Mid and Low Back Injury MTG, 4th ed., § D.2.a* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ D.2.a — Shoe Insoles and Shoe Lifts** · page 26 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § D.2.b — Kinesiotaping, Taping or Strapping {#d.2.b} *NY WCB Mid and Low Back Injury MTG, 4th ed., § D.2.b* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ D.2.b — Kinesiotaping, Taping or Strapping** · page 26 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § D.2.c — Lumbar Supports {#d.2.c} *NY WCB Mid and Low Back Injury MTG, 4th ed., § D.2.c* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ D.2.c — Lumbar Supports** · page 26 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § D.2.d — Magnets {#d.2.d} *NY WCB Mid and Low Back Injury MTG, 4th ed., § D.2.d* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ D.2.d — Magnets** · page 26 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § D.2.e — Mattresses, Water Beds, and Sleeping Surfaces {#d.2.e} *NY WCB Mid and Low Back Injury MTG, 4th ed., § D.2.e* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ D.2.e — Mattresses, Water Beds, and Sleeping Surfaces** · page 26 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § D.2.e.i — It is recommended that patients select mattresses, pillows, bedding, {#d.2.e.i} *NY WCB Mid and Low Back Injury MTG, 4th ed., § D.2.e.i* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ D.2.e.i — It is recommended that patients select mattresses, pillows, bedding,** · page 26 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § D.2.e.ii — There is no recommendation regarding mattresses other than that {#d.2.e.ii} *NY WCB Mid and Low Back Injury MTG, 4th ed., § D.2.e.ii* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ D.2.e.ii — There is no recommendation regarding mattresses other than that** · page 26 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § D.2.e.iii — There is no quality evidence to guide recommendations regarding {#d.2.e.iii} *NY WCB Mid and Low Back Injury MTG, 4th ed., § D.2.e.iii* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ D.2.e.iii — There is no quality evidence to guide recommendations regarding** · page 26 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § D.3.a — Recommended - in the management of unstable spinal fractures or cauda {#d.3.a} *NY WCB Mid and Low Back Injury MTG, 4th ed., § D.3.a* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ D.3.a — Recommended - in the management of unstable spinal fractures or cauda** · pages 26–27 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § D.3.b — Not Recommended - for the management of acute or non-acute back pain, {#d.3.b} *NY WCB Mid and Low Back Injury MTG, 4th ed., § D.3.b* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ D.3.b — Not Recommended - for the management of acute or non-acute back pain,** · page 27 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § D.4.a — Recommended - for select patients with non- acute back pain, as a {#d.4.a} *NY WCB Mid and Low Back Injury MTG, 4th ed., § D.4.a* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ D.4.a — Recommended - for select patients with non- acute back pain, as a** · page 27 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § D.4.b — Not Recommended - in patients with acute back pain. It is suggested that {#d.4.b} *NY WCB Mid and Low Back Injury MTG, 4th ed., § D.4.b* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ D.4.b — Not Recommended - in patients with acute back pain. It is suggested that** · page 27 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § D.5.a — Interferential Therapy {#d.5.a} *NY WCB Mid and Low Back Injury MTG, 4th ed., § D.5.a* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ D.5.a — Interferential Therapy** · page 27 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § D.5.b — Transcutaneous Electrical Neurostimulation (TENS) {#d.5.b} *NY WCB Mid and Low Back Injury MTG, 4th ed., § D.5.b* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ D.5.b — Transcutaneous Electrical Neurostimulation (TENS)** · pages 27–28 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § D.5.c — Percutaneous Electrical Nerve Stimulation (PENS) {#d.5.c} *NY WCB Mid and Low Back Injury MTG, 4th ed., § D.5.c* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ D.5.c — Percutaneous Electrical Nerve Stimulation (PENS)** · page 28 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § D.5.d — Microcurrent Electrical Stimulation {#d.5.d} *NY WCB Mid and Low Back Injury MTG, 4th ed., § D.5.d* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ D.5.d — Microcurrent Electrical Stimulation** · page 28 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § D.5.e — Electrical Nerve Block {#d.5.e} *NY WCB Mid and Low Back Injury MTG, 4th ed., § D.5.e* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ D.5.e — Electrical Nerve Block** · page 28 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § D.5.f — Electrical Stimulation (Physician or Therapist Applied) {#d.5.f} *NY WCB Mid and Low Back Injury MTG, 4th ed., § D.5.f* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ D.5.f — Electrical Stimulation (Physician or Therapist Applied)** · page 28 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § D.5.g — Transcutaneous Neurostimulator (TCNS) {#d.5.g} *NY WCB Mid and Low Back Injury MTG, 4th ed., § D.5.g* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ D.5.g — Transcutaneous Neurostimulator (TCNS)** · page 28 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § D.5.h — H-Wave Stimulation {#d.5.h} *NY WCB Mid and Low Back Injury MTG, 4th ed., § D.5.h* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ D.5.h — H-Wave Stimulation** · page 28 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § D.5.i — High-Voltage Galvanic {#d.5.i} *NY WCB Mid and Low Back Injury MTG, 4th ed., § D.5.i* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ D.5.i — High-Voltage Galvanic** · page 28 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § D.5.j — Iontophoresis {#d.5.j} *NY WCB Mid and Low Back Injury MTG, 4th ed., § D.5.j* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ D.5.j — Iontophoresis** · page 28 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § D.6.a — Introduction {#d.6.a} *NY WCB Mid and Low Back Injury MTG, 4th ed., § D.6.a* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ D.6.a — Introduction** · pages 29–31 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § D.6.b — Lumbar Transforaminal/Interlaminar/Caudal Epidural Injections (ESI) {#d.6.b} *NY WCB Mid and Low Back Injury MTG, 4th ed., § D.6.b* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ D.6.b — Lumbar Transforaminal/Interlaminar/Caudal Epidural Injections (ESI)** · pages 31–33 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § D.6.c — Intradiscal Steroids {#d.6.c} *NY WCB Mid and Low Back Injury MTG, 4th ed., § D.6.c* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ D.6.c — Intradiscal Steroids** · page 33 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § D.6.d — Chemonucleolysis (Chymopapain and Collagenase) {#d.6.d} *NY WCB Mid and Low Back Injury MTG, 4th ed., § D.6.d* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ D.6.d — Chemonucleolysis (Chymopapain and Collagenase)** · page 33 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § D.6.e — Tender and Trigger Point Injections {#d.6.e} *NY WCB Mid and Low Back Injury MTG, 4th ed., § D.6.e* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ D.6.e — Tender and Trigger Point Injections** · pages 33–35 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § D.6.f — Lumbar Diagnostic and Therapeutic Medial Nerve Branch Blocks or Intra-articular Facet (Zygapophyseal) Joint Injections {#d.6.f} *NY WCB Mid and Low Back Injury MTG, 4th ed., § D.6.f* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ D.6.f — Lumbar Diagnostic and Therapeutic Medial Nerve Branch Blocks or Intra-articular Facet (Zygapophyseal) Joint Injections** · pages 35–36 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § D.6.f.i — Acute back pain {#d.6.f.i} *NY WCB Mid and Low Back Injury MTG, 4th ed., § D.6.f.i* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ D.6.f.i — Acute back pain** · pages 36–37 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § D.6.f.ii — Non-acute back pain {#d.6.f.ii} *NY WCB Mid and Low Back Injury MTG, 4th ed., § D.6.f.ii* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ D.6.f.ii — Non-acute back pain** · pages 37–38 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § D.6.g — Facet Joint Hyaluronic Acid Injections {#d.6.g} *NY WCB Mid and Low Back Injury MTG, 4th ed., § D.6.g* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ D.6.g — Facet Joint Hyaluronic Acid Injections** · page 38 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § D.6.h.i — Recommended - Sacroiliac joint corticosteroid injections are {#d.6.h.i} *NY WCB Mid and Low Back Injury MTG, 4th ed., § D.6.h.i* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ D.6.h.i — Recommended - Sacroiliac joint corticosteroid injections are** · page 39 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § D.6.h.ii — Recommended - Sacroiliac joint injections are recommended {#d.6.h.ii} *NY WCB Mid and Low Back Injury MTG, 4th ed., § D.6.h.ii* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ D.6.h.ii — Recommended - Sacroiliac joint injections are recommended** · page 39 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § D.6.i — Prolotherapy Injections {#d.6.i} *NY WCB Mid and Low Back Injury MTG, 4th ed., § D.6.i* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ D.6.i — Prolotherapy Injections** · page 39 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § D.6.j — Platelet Rich Plasma (PRP) {#d.6.j} *NY WCB Mid and Low Back Injury MTG, 4th ed., § D.6.j* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ D.6.j — Platelet Rich Plasma (PRP)** · page 39 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § D.7 — Medications {#d.7} *NY WCB Mid and Low Back Injury MTG, 4th ed., § D.7* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ D.7 — Medications** · page 39 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § D.7.a — Non-Steroidal Anti-inflammatory Drugs (NSAIDs) for Treatment of Acute, Subacute, or Chronic Back Pain {#d.7.a} *NY WCB Mid and Low Back Injury MTG, 4th ed., § D.7.a* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ D.7.a — Non-Steroidal Anti-inflammatory Drugs (NSAIDs) for Treatment of Acute, Subacute, or Chronic Back Pain** · pages 39–40 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § D.7.b — NSAIDs for Patients at High Risk of Gastrointestinal Bleeding {#d.7.b} *NY WCB Mid and Low Back Injury MTG, 4th ed., § D.7.b* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ D.7.b — NSAIDs for Patients at High Risk of Gastrointestinal Bleeding** · page 40 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § D.7.c — NSAIDs for Patients at Risk for Cardiovascular Adverse Effects {#d.7.c} *NY WCB Mid and Low Back Injury MTG, 4th ed., § D.7.c* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ D.7.c — NSAIDs for Patients at Risk for Cardiovascular Adverse Effects** · page 40 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § D.7.d — Acetaminophen for Treatment of Back Pain {#d.7.d} *NY WCB Mid and Low Back Injury MTG, 4th ed., § D.7.d* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ D.7.d — Acetaminophen for Treatment of Back Pain** · pages 40–41 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § D.7.e — Topical Medications {#d.7.e} *NY WCB Mid and Low Back Injury MTG, 4th ed., § D.7.e* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ D.7.e — Topical Medications** · page 41 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § D.7.f — Opioids {#d.7.f} *NY WCB Mid and Low Back Injury MTG, 4th ed., § D.7.f* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ D.7.f — Opioids** · page 42 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § D.7.g.i — Tricyclic antidepressants (TCAs) {#d.7.g.i} *NY WCB Mid and Low Back Injury MTG, 4th ed., § D.7.g.i* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ D.7.g.i — Tricyclic antidepressants (TCAs)** · pages 42–43 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § D.7.g.ii — Selective Serotonin Reuptake Inhibitors, (e.g., paroxetine, as well as bupropion and trazodone) {#d.7.g.ii} *NY WCB Mid and Low Back Injury MTG, 4th ed., § D.7.g.ii* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ D.7.g.ii — Selective Serotonin Reuptake Inhibitors, (e.g., paroxetine, as well as bupropion and trazodone)** · page 43 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § D.7.h.i — Topiramate {#d.7.h.i} *NY WCB Mid and Low Back Injury MTG, 4th ed., § D.7.h.i* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ D.7.h.i — Topiramate** · pages 43–44 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § D.7.h.iii — Gabapentin and Pregabalin {#d.7.h.iii} *NY WCB Mid and Low Back Injury MTG, 4th ed., § D.7.h.iii* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ D.7.h.iii — Gabapentin and Pregabalin** · page 44 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § D.7.i — Colchicine (Oral and IV Colchicine) {#d.7.i} *NY WCB Mid and Low Back Injury MTG, 4th ed., § D.7.i* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ D.7.i — Colchicine (Oral and IV Colchicine)** · page 44 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § D.7.j — Compound Medications {#d.7.j} *NY WCB Mid and Low Back Injury MTG, 4th ed., § D.7.j* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ D.7.j — Compound Medications** · page 44 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § D.7.k — Skeletal Muscle Relaxants {#d.7.k} *NY WCB Mid and Low Back Injury MTG, 4th ed., § D.7.k* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ D.7.k — Skeletal Muscle Relaxants** · pages 44–46 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § D.7.l — Systemic Glucocorticosteroids (aka “Steroids”) {#d.7.l} *NY WCB Mid and Low Back Injury MTG, 4th ed., § D.7.l* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ D.7.l — Systemic Glucocorticosteroids (aka “Steroids”)** · page 46 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § D.7.l.i — Intravenous steroids {#d.7.l.i} *NY WCB Mid and Low Back Injury MTG, 4th ed., § D.7.l.i* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ D.7.l.i — Intravenous steroids** · page 46 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § D.7.m — Tumor Necrosis Factor-α Inhibitors {#d.7.m} *NY WCB Mid and Low Back Injury MTG, 4th ed., § D.7.m* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ D.7.m — Tumor Necrosis Factor-α Inhibitors** · page 46 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § D.8 — Rehabilitation {#d.8} *NY WCB Mid and Low Back Injury MTG, 4th ed., § D.8* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ D.8 — Rehabilitation** · pages 46–47 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § D.8.a — Physical / Occupational Therapy {#d.8.a} *NY WCB Mid and Low Back Injury MTG, 4th ed., § D.8.a* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ D.8.a — Physical / Occupational Therapy** · page 47 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § D.8.b — Therapeutic Exercise {#d.8.b} *NY WCB Mid and Low Back Injury MTG, 4th ed., § D.8.b* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ D.8.b — Therapeutic Exercise** · page 47 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § D.8.c — Aerobic Exercises {#d.8.c} *NY WCB Mid and Low Back Injury MTG, 4th ed., § D.8.c* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ D.8.c — Aerobic Exercises** · page 48 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § D.8.d — Strengthening and Stabilization Exercises {#d.8.d} *NY WCB Mid and Low Back Injury MTG, 4th ed., § D.8.d* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ D.8.d — Strengthening and Stabilization Exercises** · pages 48–49 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § D.8.e — Aquatic Therapy (Including Swimming) {#d.8.e} *NY WCB Mid and Low Back Injury MTG, 4th ed., § D.8.e* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ D.8.e — Aquatic Therapy (Including Swimming)** · pages 49–50 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § D.8.f — Manipulation {#d.8.f} *NY WCB Mid and Low Back Injury MTG, 4th ed., § D.8.f* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ D.8.f — Manipulation** · page 50 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § D.8.g — Manipulation under Anesthesia (MUA) and Medication-Assisted {#d.8.g} *NY WCB Mid and Low Back Injury MTG, 4th ed., § D.8.g* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ D.8.g — Manipulation under Anesthesia (MUA) and Medication-Assisted** · page 51 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § D.8.h — Massage (Manual or Mechanical) {#d.8.h} *NY WCB Mid and Low Back Injury MTG, 4th ed., § D.8.h* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ D.8.h — Massage (Manual or Mechanical)** · page 51 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § D.8.i — Mobilization (Joint) {#d.8.i} *NY WCB Mid and Low Back Injury MTG, 4th ed., § D.8.i* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ D.8.i — Mobilization (Joint)** · page 52 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § D.8.j — Mobilization (Soft Tissue) {#d.8.j} *NY WCB Mid and Low Back Injury MTG, 4th ed., § D.8.j* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ D.8.j — Mobilization (Soft Tissue)** · page 52 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § D.8.k — Superficial Heat and Cold {#d.8.k} *NY WCB Mid and Low Back Injury MTG, 4th ed., § D.8.k* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ D.8.k — Superficial Heat and Cold** · page 53 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § D.8.l — Diathermy {#d.8.l} *NY WCB Mid and Low Back Injury MTG, 4th ed., § D.8.l* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ D.8.l — Diathermy** · page 53 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § D.8.m — Low Level Laser Therapy {#d.8.m} *NY WCB Mid and Low Back Injury MTG, 4th ed., § D.8.m* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ D.8.m — Low Level Laser Therapy** · page 53 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § D.8.n — Infrared Therapy {#d.8.n} *NY WCB Mid and Low Back Injury MTG, 4th ed., § D.8.n* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ D.8.n — Infrared Therapy** · page 53 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § D.8.o — Ultrasound {#d.8.o} *NY WCB Mid and Low Back Injury MTG, 4th ed., § D.8.o* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ D.8.o — Ultrasound** · page 53 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § D.8.p — Reflexology {#d.8.p} *NY WCB Mid and Low Back Injury MTG, 4th ed., § D.8.p* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ D.8.p — Reflexology** · page 54 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § D.8.q — Neuroflexotherapy {#d.8.q} *NY WCB Mid and Low Back Injury MTG, 4th ed., § D.8.q* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ D.8.q — Neuroflexotherapy** · page 54 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § D.8.r — Traction {#d.8.r} *NY WCB Mid and Low Back Injury MTG, 4th ed., § D.8.r* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ D.8.r — Traction** · page 54 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § D.8.s — Vertebral Axial Compression (VAX-D) and Other Decompressive {#d.8.s} *NY WCB Mid and Low Back Injury MTG, 4th ed., § D.8.s* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ D.8.s — Vertebral Axial Compression (VAX-D) and Other Decompressive** · page 54 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § D.9 — Therapy – Ongoing Maintenance Care {#d.9} *NY WCB Mid and Low Back Injury MTG, 4th ed., § D.9* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ D.9 — Therapy – Ongoing Maintenance Care** · pages 54–55 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § D.10 — Radiofrequency Ablation, Neurotomy, Facet Rhizotomy {#d.10} *NY WCB Mid and Low Back Injury MTG, 4th ed., § D.10* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ D.10 — Radiofrequency Ablation, Neurotomy, Facet Rhizotomy** · pages 55–56 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § D.10.a — Post-Procedure Therapy {#d.10.a} *NY WCB Mid and Low Back Injury MTG, 4th ed., § D.10.a* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ D.10.a — Post-Procedure Therapy** · page 56 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § D.10.b — Repeat Radiofrequency Neurotomy (or additional level radiofrequency neurotomies) {#d.10.b} *NY WCB Mid and Low Back Injury MTG, 4th ed., § D.10.b* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ D.10.b — Repeat Radiofrequency Neurotomy (or additional level radiofrequency neurotomies)** · page 56 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § D.10.c — Dorsal Root Ganglia Radiofrequency Lesioning {#d.10.c} *NY WCB Mid and Low Back Injury MTG, 4th ed., § D.10.c* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ D.10.c — Dorsal Root Ganglia Radiofrequency Lesioning** · page 56 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § D.10.d — Intradiscal Electrothermal Therapy (IDET) {#d.10.d} *NY WCB Mid and Low Back Injury MTG, 4th ed., § D.10.d* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ D.10.d — Intradiscal Electrothermal Therapy (IDET)** · page 57 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § D.10.e — Percutaneous Intradiscal Radiofrequency Thermocoagulation (PIRFT) {#d.10.e} *NY WCB Mid and Low Back Injury MTG, 4th ed., § D.10.e* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ D.10.e — Percutaneous Intradiscal Radiofrequency Thermocoagulation (PIRFT)** · page 57 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § E.1 — Discectomy, Microdiscectomy, Sequestrectomy, Endoscopic {#e.1} *NY WCB Mid and Low Back Injury MTG, 4th ed., § E.1* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ E.1 — Discectomy, Microdiscectomy, Sequestrectomy, Endoscopic** · page 57 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § E.1.a — Lumbar Discectomy {#e.1.a} *NY WCB Mid and Low Back Injury MTG, 4th ed., § E.1.a* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ E.1.a — Lumbar Discectomy** · pages 57–58 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § E.1.b — Percutaneous Discectomy {#e.1.b} *NY WCB Mid and Low Back Injury MTG, 4th ed., § E.1.b* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ E.1.b — Percutaneous Discectomy** · page 58 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § E.2 — Adhesiolysis {#e.2} *NY WCB Mid and Low Back Injury MTG, 4th ed., § E.2* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ E.2 — Adhesiolysis** · page 58 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § E.3 — Decompressive Surgery (Laminotomy / Facetectomy Laminectomy {#e.3} *NY WCB Mid and Low Back Injury MTG, 4th ed., § E.3* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ E.3 — Decompressive Surgery (Laminotomy / Facetectomy Laminectomy** · page 58 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § E.4 — Spinal Fusion {#e.4} *NY WCB Mid and Low Back Injury MTG, 4th ed., § E.4* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ E.4 — Spinal Fusion** · pages 58–59 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § E.4.a — Spinal Fusion with Third Discectomy {#e.4.a} *NY WCB Mid and Low Back Injury MTG, 4th ed., § E.4.a* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ E.4.a — Spinal Fusion with Third Discectomy** · page 59 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § E.5 — Electrical Bone Growth Stimulators {#e.5} *NY WCB Mid and Low Back Injury MTG, 4th ed., § E.5* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ E.5 — Electrical Bone Growth Stimulators** · page 59 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § E.6 — Disc Replacement {#e.6} *NY WCB Mid and Low Back Injury MTG, 4th ed., § E.6* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ E.6 — Disc Replacement** · pages 60–61 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § E.7 — Vertebroplasty and Kyphoplasty {#e.7} *NY WCB Mid and Low Back Injury MTG, 4th ed., § E.7* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ E.7 — Vertebroplasty and Kyphoplasty** · page 61 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § E.8 — Sacroiliac Surgery {#e.8} *NY WCB Mid and Low Back Injury MTG, 4th ed., § E.8* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ E.8 — Sacroiliac Surgery** · pages 61–63 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § E.9 — Intraoperative Monitoring / Image Guidance / Robotic {#e.9} *NY WCB Mid and Low Back Injury MTG, 4th ed., § E.9* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ E.9 — Intraoperative Monitoring / Image Guidance / Robotic** · page 63 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d). --- ## Mid and Low Back Injury MTG § E.10 — Implantable Spinal cord Stimulators (SCS) {#e.10} *NY WCB Mid and Low Back Injury MTG, 4th ed., § E.10* Official source: _NY WCB Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition (January 26, 2021), effective for treatment on or after 2022-05-02 — governing edition per 12 NYCRR § 324.2(a)(1)._ **§ E.10 — Implantable Spinal cord Stimulators (SCS)** · page 63 of the guideline. The guideline text is published by the Workers' Compensation Board and is not reproduced here. Read the section in the WCB PDF (link above). Care that departs from the guideline requires a variance under 12 NYCRR § 324.3; procedures over $1,000 that follow it are pre-authorized under § 324.2(d).