Coverage of Conditions and Treatments (Coverage Decisions)

Use this lookup tool to determine coverage decisions, or if prior authorization is needed for the treatment or condition. Note: For Self-insured employer claims, you must contact the employer or their claims administrator.

List also available in PDF format.

Archived Coverage Decisions.

See Treatment Guidelines and Resources for additional information.

Coverage decision

Not Covered

L&I’s Office of the Medical Director has determined that the HTCC’s determination about genomic microarray for diagnosing genetic abnormalities in children does not apply to Washington’s workers’ compensation, which only covers work-related injuries or occupational disease.

Background Information

The State Health Technology Clinical Committee (HTCC) first reviewed genomic microarray for diagnosing genetic abnormalities in children and made a determination in May 2016, which was finalized on July 8, 2016. The committee’s determination, based on a systematic review of the evidence of safety, efficacy and cost-effectiveness, is that the testing is a covered benefit with conditions for children with congenital anomalies, intellectual disability or autism spectrum disorder. Complete information on this HTCC determination is available here:  What we're working on | Washington State Health Care Authority.