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Minnesota Department of Labor and Industry

Workers' compensation -- Medical benefits

Parameters for surgery

Minnesota Rules Part 5221.6500 provides parameters for surgery. The health care provider must give the insurer prior notification before proceeding with any elective inpatient surgery. Emergency surgery may proceed without prior notification. The reasonableness and necessity of any emergency surgery can be reviewed retrospectively, based on the medical information that was available at the time of the emergency surgery. There are specific subparts that cover spinal surgery, upper extremity surgery and lower extremity surgery. These are the only specific parameters that apply to lower extremity conditions.

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