DWD 81.05(2)(d)4. 4. Suspected discitis.

DWD 81.05(2)(e) (e) Except as specified in par. (d), a health care provider may not order magnetic resonance imaging scanning in the first 4 weeks after an injury. Magnetic resonance imaging scanning is necessary after 4 weeks if the patient continues with symptoms and physical findings after the course of initial nonsurgical care and if the patient’s condition prevents the resumption of the regular activities of daily life, including regular vocational activities.

DWD 81.05(2)(f) (f) A health care provider may order myelography for any of the following:

DWD 81.05(2)(f)1. 1. Myelography may be substituted for otherwise necessary computed tomography scanning or magnetic resonance imaging scanning in accordance with pars. (b) and (d), if those imaging modalities are not locally available.

DWD 81.05(2)(f)2. 2. In addition to computed tomography scanning or magnetic resonance imaging scanning, if there are progressive neurologic deficits or changes and computed tomography scanning or magnetic resonance imaging scanning has been negative.

DWD 81.05(2)(f)3. 3. For preoperative evaluation in cases of surgical intervention, but only if computed tomography scanning or magnetic resonance imaging scanning have failed to provide a definite preoperative diagnosis.

DWD 81.05(2)(g) (g) A health care provider may order computed tomography myelography for any of the following:

DWD 81.05(2)(g)1. 1. The patient’s condition is predominantly sciatica, there has been previous spinal surgery, and tumor is suspected.

DWD 81.05(2)(g)2. 2. The patient’s condition is predominantly sciatica, there has been previous spinal surgery, and magnetic resonance imaging scanning is equivocal.

DWD 81.05(2)(g)3. 3. When spinal stenosis is suspected and the computed tomography scanning or magnetic resonance imaging scanning is equivocal.

DWD 81.05(2)(g)4. 4. If there are progressive neurologic symptoms or changes and computed tomography scanning or magnetic resonance imaging scanning has been negative.

DWD 81.05(2)(g)5. 5. For preoperative evaluation in cases of surgical intervention, but only if computed tomography scanning or magnetic resonance imaging scanning have failed to provide a definite preoperative diagnosis.

DWD 81.05(2)(h) (h) A health care provider may order intravenous enhanced computed tomography scanning only if there has been previous spinal surgery, and the imaging study is being used to differentiate scar due to previous surgery from disc herniation or tumor, but only if intrathecal contrast for computed tomography-myelography is contraindicated and magnetic resonance imaging scanning is not available or is also contraindicated.

DWD 81.05(2)(i) (i) A health care provider may order enhanced magnetic resonance imaging scanning for any of the following:

DWD 81.05(2)(i)1. 1. There has been previous spinal surgery, and the imaging study is being used to differentiate scar due to previous surgery from disc herniation or tumor.

DWD 81.05(2)(i)2. 2. Hemorrhage is suspected.

DWD 81.05(2)(i)3. 3. Tumor or vascular malformation is suspected.

DWD 81.05(2)(i)4. 4. Infection or inflammatory disease is suspected.

DWD 81.05(2)(i)5. 5. Unenhanced magnetic resonance imaging scanning was equivocal.

DWD 81.05(2)(j) (j) A health care provider may order discography for any of the following:

DWD 81.05(2)(j)1. 1. All of the following are present:

DWD 81.05(2)(j)1.a. a. Back pain is the predominant complaint.

DWD 81.05(2)(j)1.b. b. The patient has failed to improve with initial nonsurgical management.

DWD 81.05(2)(j)1.c. c. Other imaging has not established a diagnosis.

DWD 81.05(2)(j)1.d. d. Lumbar fusion surgery or other surgical procedures are being considered as a therapy.

DWD 81.05(2)(j)2. 2. There has been previous spinal surgery, and pseudoarthrosis, recurrent disc herniation, annular tear, or internal disc disruption is suspected.

DWD 81.05(2)(k) (k) A health care provider may order computed tomography discography when it is necessary to view the morphology of a disc.

DWD 81.05(2)(L) (L) A health care provider may not order nuclear isotope imaging including technicium, indium, and gallium scans, unless tumor, stress fracture, infection, avascular necrosis, or inflammatory lesion is suspected on the basis of history, physical examination findings, laboratory studies, or the results of other imaging studies.

DWD 81.05(2)(m) (m) A health care provider may not order thermography for the diagnosis of any of the clinical categories of low back conditions in s. DWD 81.06 (1) (b).