§ 9768.10. Independent Medical Review Application (Form).

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SPECIALTY CODES

MAI Allergy and Immunology

MAA Anesthesiology

MRS Colon & Rectal Surgery

MDE Dermatology

MEM Emergency Medicine

MFP Family Practice

MPM General Preventive Medicine Hand - Orthopaedic Surgery, Plastic Surgery, General Surgery

MMM Internal Medicine

MMV Internal Medicine - Cardiovascular Disease

MME Internal Medicine - Endocrinology Diabetes and Metabolism

MMG Internal Medicine - Gastroenterology

MMH Internal Medicine - Hematology

MMI Internal Medicine - Infectious Disease

MMO Internal Medicine - Medical Oncology

MMN Internal Medicine - Nephrology

MMP Internal Medicine - Pulmonary Disease

MMR Internal Medicine - Rheumatology

MPN Neurology

MNS Neurological Surgery

MNM Nuclear Medicine

MOG Obstetrics and Gynecology

MPO Occupational Medicine

MOP Opthalmology

MOS Orthopaedic Surgery

MTO Otolaryngology

MAP Pain Management - Psychiatry and Neurology, Physical Medicine and Rehabilitation, Anesthesiology

MHA Pathology

MEP Pediatrics

MPR Physical Medicine & Rehabilitation

MPS Plastic Surgery

MPD Psychiatry

MRD Radiology

MSY Surgery

MSG Surgery - General Vascular

MTS Thoracic Surgery

MTX Toxicology - Preventive Medicine, Pediatrics, Emergency

MUU Urology

POD Podiatry

DWC Form 9768.10

May 2007

HISTORY

1. New section filed 12-31-2004 as an emergency; operative 1-1-2005 (Register 2004, No. 53). A Certificate of Compliance must be transmitted to OAL by 5-2-2005 or emergency language will be repealed by operation of law on the following day.

2. Certificate of Compliance as to 12-31-2004 order, including amendment of section heading and section, transmitted to OAL 4-29-2005 and filed 6-10-2005 (Register 2005, No. 23).

3. Change without regulatory effect amending form filed 10-18-2006 pursuant to section 100, title 1, California Code of Regulations (Register 2006, No. 42).

4. Change without regulatory effect amending section filed 5-23-2007 pursuant to section 100, title 1, California Code of Regulations (Register 2007, No. 21).

Note

Note: Authority cited: Sections 133 and 4616, Labor Code. Reference: Sections 4616.3 and 4616.4, Labor Code.