News

Effective August 15, 2019, WSI is implementing plan limits for maximum daily dosages of Lyrica® (Pregabalin). This is applicable to both a new and existing prescription.

Dr. Mandi Johnson, MD, FAAFP, MPH will join WSI as Medical Director effective July 1, 2019. As Medical Director, Dr. Johnson will provide medical consultation services and assist with policy and procedure development for WSI.

Effective April 1, 2019, WSI will no longer require all total knee arthroplasty procedures be performed in the inpatient hospital setting. The Utilization Review (UR) department will now allow for the approval of a total knee arthroplasty described by CPT codes 27446 or 27447 in the outpatient hospital and ambulatory surgical center settings.

WSI has recently received an increase in incomplete prior authorization requests for elective lumbar fusion surgeries.

WSI reimburses for vision correction materials (e.g. eyeglasses, contact lenses) when prescribed and deemed appropriate for an accepted workers compensation claim.

Effective for dates of service on and after January 1, 2019, WSI has implemented a new code, W0420, for a provider to bill when instructing an injured worker on the use of a TENS unit.

Effective January 1, 2019, WSI will implement the following fee schedule changes. Click here to access the full fee schedules.

WSI recently published an article about the Advanced Beneficiary Notice (ABN) process.  After receiving several follow-up questions from providers about the article, WSI is providing further clarification.

WSI requires a provider complete the Advanced Beneficiary Notice of Non-Coverage (ABN) form for each individual date of service.

Effective October 1, 2018, WSI requires an annual renewal of authorization for a brand name medication in lieu of a generic equivalent.