Local Medical Review Policy



    ALL     Glucose Gly Hgb Lipids Iron Mg++ Thyroid Digoxin Troponin
CBC   PSA     CA-125   FOB Urine CS H. Pylori Protime PTT
Sedimentation Rate
CT of head CT orbit, sella CT maxfacial CT neck soft CT cervical CT thoracic CT lumbar
CT upper ext CT lower ext CT chest CT abdomen CT pelvis CT abd/pelvis
Bone mass Mamm diag Mamm screen ECG Pulm Function

  Search term or ICD9 code:      


Data updated April 6, 2014.     LMRP Tool © 2006 Tony Witte, MD.   Last modified May 24, 2008.