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Utilization Review · IMR-2026-0418Apr 18, 2026

Notice of Non-Certification

Claimant[Patient]DOI[Date of Injury]HCPCSE0218 · Cold compression

The requested durable medical equipment is not certified based on a review of submitted documentation under MTUS guidelines.

DENIED
Appeal Draft · Strata-A-0418Overturned

Request for Independent Medical Review

Re: Non-certification dated April 18, 2026, for E0218 cold compression therapy following arthroscopic repair. The denial fails to address the treating physician's documented findings of post-surgical edema and prescribed post-op protocol.

MTUS Citation8 CCR §9792.24.2(c)(1) · Postsurgical Treatment Guidelines, Knee. Cold therapy is supported for the immediate post-operative period.

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