For Providers
Clinic/Facility Personnel Changes
Upcoming CME Opportunity
Updates from L&I
1) Online Communications and Activity Prescription Forms (APFs)
2) Concerns About Workplace Hazards
3) Release of Medical Records and Patient Privacy In Workers’ Compensation
4) Return of the Physician Final Report (PFR) Form on Medical Only Claims
5) Change in Coverage for TENS, IFC, and PNT Device
Clinic/Facility Personnel Changes
Have there been any personnel changes to your clinic or facility? Remember to provide updates to the COHE office anytime:
• a Provider joins or leaves your organization;
• your COHE contact person changes; and/or
• you have a new physical or mailing address, telephone number, or email address
To view the current information COHE has on file for your organization, you may access our website, www.gocohe.com, and click on “Participants Eastern WA COHE”, then “Participating Providers”, then choose the county and facility by name. Or you may contact Carol Thornburg at (509) 456-3222 or toll free at (866) 247-2643. Employer information may be updated via phone by contacting Carol or via email (coheinfo@st-lukes.org).
Upcoming Continuing Medical Education OpportunityMark your calendars and save this date! The Eastern Washington COHE, in collaboration with the Department of Labor & Industries will be offering Advanced Topics in Washington Workers' Compensation: Physical Capacity Calculation and Return-to-Work, Emphasizing Chronicity and Pain Patients to COHE providers, their key office staff, and any other interested provider. The seminar is scheduled for Saturday, June 19, 2010 from 8:00a to 5:00p, in beautiful Wenatchee, WA. This program has been co-sponsored by the Eastern WA COHE two previous times, generating accolades from the attendees. This is an all-day program that is provided at"no-cost" to participating Eastern WA COHE providers. Watch your email and the COHE website for registration brochures and more information.
Updates from L&I The Centers of Occupational Health & Education (COHEs) strive to continue educating COHE providers regarding Department of Labor and Industries (L&I) processes and specific billing issues as part of their ongoing service. The following articles include some reminders, updates or recent changes that may impact COHE providers.
1) Online Communications and Activity Prescription Forms (APFs)
A. Billing Code: Online Communications - Physician – 99444; Non-physician – 98 969.
B. See the link to L&I’s Medical Aid Rules & Fee Schedule (MARFs) for information on billing and documentation requirements for online communications. Click here to see page 38.
C. Use of the above billing codes is not appropriate for faxing or e-mailing a document such as an APF. Other services not payable include:
• Routine requests for appointments.
• Test results that are informational only.
• Requests for prescription refills.
• Consultations that result in an office visit
2) Concerns About Workplace Hazards
Washington healthcare providers send the Department of Labor and Industries (L&I) more than 140,000 worker injury reports each year – putting them in a unique position to know about specific hazards that exist in their patients’ workplace. Below are some examples of workplace safety issues that have been identified by healthcare providers.
A physician noticed several employees had burns on the forearms and contacted the employer to recommend longer gloves, which the employer purchased.
A physician working in an Emergency Department contacted their local DOSH resource after they treated 14-16agriculture workers over a few days due to falls off of ladders.
An emergency department nurse treated a man for a skin rash that began when he started washing out bins at a commercial laundry.
An occupational physician reported he treated an employee with metal shards in his eye who wasn’t wearing safety glasses on the job.
Providers have several options if they notice a trend or a “sentinel” event. (All information will be kept confidential unless there is a public information request.)
• Call L&I’s Division of Occupational Safety & Health (DOSH) toll-free line 1-800-423-7233
º Press 2: “All other safety and health issues”, then
º Press 3: “To report unsafe working conditions or workplace safety discrimination”, then
º Press 1: “To report an unsafe working condition”
º If the staff cannot answer your call right away, you will be asked to leave a voice mail. Someone will return your call.
• Contact a local DOSH representative, click here for contact information in various regions of the state.
• Follow-up with the employer.
3) Release of Medical Records and Patient Privacy In Workers’ Compensation
The federal Health Insurance Portability & Accountability Act (HIPAA) permits you to provide records for workers compensation claims and cases when state law requires it.
Washington State law says you must promptly provide these records when requested by the Department of Labor and Industries or by a self-insured employer.
HIPAA also allows you to disclose personal health information without an authorization directly to employers regarding work-related illnesses or injuries or to the legal representatives of either the worker or his or her employer.
When a provider fails to provide medical records when requested, it causes delay in the management of injured workers’ claims, and can result in unnecessary hardship on the workers and their families.
If you have additional questions regarding the how HIPAA affects your legal obligation to provide records under Washington State law, please contact your legal counselor.
4) Return of the Physician Final Report (PFR) Form on Medical Only Claims
Effective October 1, 2009, the department reinstated a modified PFR on simple medical or dental claims where no time has been missed from work due to the injury. This change is being made to reduce the burden on health care providers who were asked to complete an APF for final medical on claims where there had been no physical restrictions and conservative treatment.
We received feedback from health care providers, employers and claim managers (CMs) that requesting an APF on these simple claims also caused confusion about work status. The CM will send a PFR to the attending provider for completion. The attending provider should:
• Complete the form based on the treatment record of the worker’s last visit.
• Annotate the form if the worker is no longer in your care.
• Return the PFR to the department.
• Bill code 1026M for this service.
5) Change In Coverage for TENS, IFC, and PNT Device
Effective March 1, 2010, Transcutaneous Electrical Nerve Stimulation (TENS), Interferential Current Therapy (IFC) and Percutaneous Neuromodulation Therapy (PNT) devices for use outside of medically supervised facility settings are not covered.
Transcutaneous Electrical Nerve Stimulation (TENS), Interferential Current Therapy (IFC) and Percutaneous Neuromodulation Therapy (PNT) devices for use outside of medically supervised facility settings are not covered for State Fund, Self-Insured and Crime victims claims. This includes home use, purchase or rental of Durable Medical Equipment (DME) and supplies. Use of these therapies will continue to be covered during hospitalization and in supervised facility settings.
For access to updated and complete information to this coverage decision please click here. To print a copy of Provider Bulletin PB 10-01 visit the L&I Website: http://www.lni.wa.gov/ClaimsIns/Providers/Billing/ProvBulletins/default.asp.
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