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Clinical Trials

Clinical trials drive medical innovation, offering patients access to cutting-edge treatments before they become widely available. These carefully controlled studies evaluate the safety and effectiveness of new drugs, therapies, and medical procedures, ensuring advancements in healthcare. Participants not only receive expert medical care but also contribute to the future of medicine. By joining a clinical trial, you help shape the next breakthrough in treatment while potentially benefiting from the latest medical advancements.

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About OIP Clinical Trials

Clinical trials are the foundation of medical progress, providing patients with early access to groundbreaking treatments while advancing the science behind healthcare. These meticulously designed studies assess the safety, efficacy, and potential benefits of new drugs, therapies, and medical procedures before they become widely available. By participating in a clinical trial, individuals not only receive close medical supervision and cutting-edge care but also play a vital role in shaping the future of medicine. Each trial contributes to a growing body of knowledge, helping researchers refine treatments, uncover new cures, and improve the overall standard of care. In addition to benefiting from innovative therapies, participants become part of a global effort to combat diseases and enhance the well-being of future generations. With rigorous ethical and regulatory oversight, clinical trials ensure that new medical advancements meet the highest safety and effectiveness standards before reaching the broader public.

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MRI Upper Extremity (Shoulder, Upper Arm, Elbow, Forearm, Wrist, or Hand) Preauthorization Documentation Guidelines

1. Suspicious mass or tumor
      a. On initial evaluation or follow up
2. Staging of known cancer
3. Suspected or known infection (septic arthritis or osteomyelitis)
4. Suspected Osteonecrosis
5. Evaluation of Rheumatoid Arthritis or other autoimmune diseases
6. Evaluation of Post-op Complications
      a. Infection, delayed union, other
7. Suspected fracture with prior imaging non-diagnostic
8. Abnormal bones scan with non-diagnostic Xray
9. Significant injury with suspected ligament, cartilage, tendon, nerve or bone injury with non-diagnostic prior imaging
      a. Suspected massive rotator cuff tear
10. Evaluation of pain or more minor injury with initial imaging non-diagnostic:
      a. Pain lasting 3 months or greater
      b. Failed conservative therapy: Must include each one:
           i. Rest: modified activities or assistive devices/rigid splints or braces
           ii. Ice or heat
           iii. Medications and/or injections
           iv. Physical therapy or a physician directed home exercise program
           or chiropractic care
                1. Document instructions given
                2. Document compliance and results
                3. Document duration and dates

MRI Spine Preauthorization Documentation Criteria

1. Tumor, masses, or cancer: suspected or known
2. Neurological Deficits
3. Trauma or acute injury
       a. With neurological deficits
       b. With progressive symptoms during conservative treatment
4. Infection: known or suspected
5. Inflammation: Ankylosing Spondylitis
6. Pre-op Evaluation
7. Post-op Complications
8. Acute or Chronic Axial or radicular pain
       a. Pain lasting 6 weeks or greater
       b. ADLs must be affected
       c. Progressive neurological deficit or an abnormal EMG
             i. Must document specific dermatome, muscle weakness, reflex
abnormalities
       d. Failed conservative therapy: Must include each one:
             i. Rest: modified activities or bracing
             ii. Ice or heat
             iii. Medications, acupuncture or stimulators
                   1. Specific name of medication start date and duration and
                   results
             iv. Epidurals or other injections (not trigger point injections)
             v. Physical therapy or a physician directed home exercise program
             or chiropractic care
                   1. Document instructions given
                   2. Document compliance and results
                   3. Document duration and dates

MRI Pelvis Preauthorization Documentation Criteria

1. Musculoskeletal Pelvic MRI:
     a. Mass or tumor
    b. Significant injury to rule out fracture or other injury
    c. Osteonecrosis of hips
    d. Sacroiliitis
    e. Sacroiliac joint dysfunction
    f. Pain lasting 3 months or greater
    g. Failed conservative therapy: Must include each one:
            i. Rest: modified activities or assistive devices/rigid
            splints or braces
            ii. Ice or heat
            iii. Medications and/or injections
            iv. Physical therapy or a physician directed home
            exercise program or chiropractic care
                    1. Document instructions given
                    2. Document compliance and results
                    3. Document duration
    h. Persistent Pain not responsive to 4 weeks of conservative treatment

2. Prostate Cancer Evaluation, follow up, and surveillance

3. Mass or Tumors

4. Cancer detection, staging, or surveillance
    a. 3, 6, or 12 month follow up

5. Infection:
        a. Appendicitis
        b. Diverticulitis not responding to conservative care
        c. Inflammatory bowel disease
        d. Abscess suspected
        e. Fistula
        f. Abnormal fluid collection

6. Pelvic Floor failure

7. Uterine abnormalities

8. Undescended Testes

9. Pre-op Evaluation

10. Post-op Complication

MRI Lower Extremity (Hip, Knee, Leg, Ankle, or Foot) Preauthorization Documentation Guidelines

1. Suspicious Mass or Tumor
       a. On initial evaluation or follow up
2. Staging of known Cancer
3. Known or suspected infection
4. Suspected Osteonecrosis or Legg-Calve-Perthes Disease
5. Suspected SCFE, tarsal coaltion
6. Evaluation of Post-op complication:
       a. Infection, delayed union, other
7. Suspected fracture with prior imaging non-diagnostic
8. Abnormal bone scan with non-diagnostic xray
9. Significant injury with suspected ligament, cartilage, or bone injury
10. Evaluation of pain or more minor injury with initial imaging negative:
       a. Pain lasting 3 months or greater
       b. Failed conservative therapy: Must include each one:
             i. Rest: modified activities or assistive devices/rigid splints or braces
             ii. Ice or heat
             iii. Medications and/or injections
             iv. Physical therapy or a physician directed home exercise program orchiropractic care
                  1. Document instructions given
                   2. Document compliance and results
                   3. Document duration

MRI Chest Preauthorization Documentation Guidelines

1. Mediastinal or hilar mass
2. Myasthenia gravis with suspected thymoma
3. Brachial Plexus Dysfunction
4. Thoracic/Thoracoabdominal aneurysm
5. Suspected or confirmed Congenital Heart Disease
6. Thoracic Outlet Syndrome

MRI Brain Preauthorization Documentation Criteria

1. Suspected or known MS
2. Seizure disorder, known or suspected new or refractory
3. Suspected Parkinson’s disorder
4. Neurological symptoms or deficits
     a. Acute, new or fluctuating deficits
5. Mental status changes
6. Trauma to the head with neurological changes, vomiting, headache
7. Evaluation of headaches
      a. Chronic with change in pattern/character
      b. Sudden onset severe headache
      c. New onset headache in pregnancy
8. Suspected brain tumor or cancer
9. Known or suspected stroke
10. Suspected Infection
11. Suspected Congenital abnormality
12. New onset tinnitus or vertigo associated with visual changes

MRI Abdomen and MRCP Preauthorization Documentation Criteria

MRI
1. Suspicious Mass or Tumor
2. Surveillance of Mass, Tumor, or Cancer    
      a. 3, 6, 12 month follow up
3. Suspected infection:
      a. Appendicitis
      b. Peritonitis
      c. Pancreatitis
      d. Inflammatory bowel disease
      e. Cholecystitis
      f. Abscess
      g. Fistula
      h. Hepatitis C
4. Preoperative Evaluation
5. Post-op complication

MRCP
1. Suspected Congenital Abnormality
2. Chronic pancreatitis or related complications
3. Biliary tree symptoms
4. Pre-op Evaluation
5. Post-op complication or surveillance
6. Inconclusive abnormalities identified on other imaging