Medical Providers News

April 2017
WSI has discontinued the pilot program for medical appeal time frames, which extended the medical bill appeal time frame from 30 days to 60 days.
April 2017
Effective immediately, a provider may submit professional charges (CMS-1500/837p) and documentation electronically to WSI through iHCFA.
February 2017
WSI recently implemented Documentation Policies to reinforce existing guidelines and/or clarify documentation standards.
January 2017
Effective January 1, 2017, WSI will implement the following fee schedule changes.
June 2016
Effective July 1, 2016, WSI is initiating a pilot program in which a chiropractor will be required to obtain prior authorization for chiropractic treatment extending beyond the initial office visit.
June 2016
Effective July 1, 2016, WSI will implement a new process to enforce the exclusive use of the Medical Bill Appeal (M6) form.
May 2016
Effective June 1, 2016, WSI will only accept a request to retrospectively review a rendered service that was not prior authorized after the provider has submitted a bill and received a denial for that service.
May 2016
WSI recently published a new medical policy, Chronic Opioid Therapy. This policy is a result of the 2015 North Dakota Legislative Assembly amending North Dakota Century Code (N.D.C.C.) § 65-05-39 to address chronic opioid therapy.
April 2016
WSI recently revised the UR-Chiro form and providers should use the revised form effective immediately.
March 2016
Effective April 1, 2016, Workforce Safety & Insurance (WSI) will require submission of the newly developed Pain Questionnaire and Surgery Expectation Questionnaire forms when requesting a prior authorization request for a lumbar fusion surgery.
January 2016
Effective for dates of service in 2016, WSI adopted new CMS standards regarding billing for drugs of abuse.
January 2016
Effective January 1, 2016, WSI implemented the following fee schedule changes.
January 2016
WSI has restructured the Fee Schedule Guidelines, offering a more user-friendly product for 2016.
January 2016
Effective January 1, 2016, WSI adopted the new conditional packaging rules implemented by CMS for 2016.
January 2016
WSI recently changed the standard for billing a unilateral procedure performed bilaterally in order to align with CMS.
January 2016
Effective March 1, 2016, WSI will require prior authorization of speech therapy by the Utilization Review (UR) department.
January 2016
Effective March 1, 2016, WSI will implement changes regarding the coverage of massage therapy treatment.
October 2015
WSI recently revised the UR-Chiro form and providers should use the revised form effective immediately.
October 2015
WSI has recently begun publishing fillable PDF versions of commonly used forms.
October 2015
WSI has restructured and added new functionality to the Fee Schedule section of our website.
August 2015
WSI recently modified the Capability Assessment (C3) form and providers should use it effective immediately.
August 2015
Effective for dates of service beginning September 1, 2015, WSI will not reimburse for procedures billed with HCPCS Temporary National Codes (T Codes).
August 2015
Effective for dates of service beginning September 1, 2015, WSI will deny durable medical equipment, prosthetics, orthotics, supplies (DMEPOS) billed with a miscellaneous code if a more specific code is available.
August 2015
WSI has recently begun publishing medical treatment guidelines, which WSI uses in the Utilization Review and Claim management process.
July 2015
On August 1, 2015, WSI will utilize US Script®, to provide the same point-of-sale transactions currently in place with tmesys®.
June 2015
The 2015 North Dakota Legislative Assembly amended North Dakota Century Code (N.D.C.C.) to address the legal protection of a healthcare provider when disclosing medical information to WSI.
June 2015
Beginning October 1, 2015, WSI will transition from the use of ICD-9 to ICD-10 for diagnosis and procedure codes in alignment with federal regulations.
March 2015
This article highlights significant changes in billing for drugs of abuse testing codes in the Clinical Laboratory Fee Schedule.
March 2015
Effective April 1, 2015, WSI will implement two new forms, Independent Exercise Request (C59a) and Work Hardening or Conditioning Request (C59b).
January 2015
WSI recently revised the UR-C form and providers should use the revised form effective immediately.
January 2015
Effective February 1, 2015, WSI will require prior authorization of long-acting opioid medication.
January 2015
Effective March 1, 2015, WSI will only accept a request for adjustment (appeal) of a processed charge on the Provider Request for Adjustment (M6) form.
January 2015
Effective February 1, 2015, WSI will discontinue the pilot program waiving prior authorization for an MRI.
December 2014
Effective January 1, 2015, WSI will implement the following fee schedule changes.
December 2014
Effective January 1, 2015, WSI will require the primary diagnosis code for an inpatient hospital charge.
December 2014
Effective January 1, 2015, WSI will implement a pilot program to lengthen the appeal timeframe for a disputed medical charge.
November 2014
Effective January 1, 2015 WSI will adopt CMS guidelines, which require red and white versions of the CMS 1500 and UB-04.
July 2014
This article highlights a significant change in billing of lab work provided in the outpatient hospital setting.
March 2014
Effective with dates of service beginning May 1, 2014, WSI will adopt the guidelines highlighted below in the auditing of Evaluation and Management (E/M) documentation.
March 2014
WSI does not cover H-wave electrical stimulation, as it is investigational and experimental.
February 2014
form, Post Injection Pain Response Note, is available for providers to document response to an injection.
February 2014
Facilities should use the WSI specific procedure code, W0555, when billing for Independent Exercise Program (IEP).
February 2014
WSI has identified healthcare providers billing services to Medicare when WSI is the primary payer.
January 2014
The following information provides clarification on reimbursement and prior authorization for hearing aids and associated services.
December 2013
Effective October 1, 2013, WSI will no longer approve new requests for use of the continuous-flow cryotherapy units, e.g. Game Ready™ Accelerated Recovery System.
December 2013
In January 2013, WSI issued a Provider Bulletin detailing criteria for the workability assessment program.
October 2013
On November 1, 2013, WSI will utilize PMSI® d.b.a. tmesys®, to provide the same point-of-sale transactions currently in place with US Script®.
May 2013
Bloodborne pathogen exposure claims need to be billed with modifier 22 added to the charges for the source patient.