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Updated Fee Schedule effective January 1, 2020

Categories: all, Medical Provider All News, Medical Provider Billing

Effective January 1, 2020, WSI will implement the fee schedule changes described below.  WSI will publish a subsequent news article notification when the 2020 Fee Schedules files are available.


New Fee Schedule for Long-Term Care Hospitals

Categories: all, Medical Provider All News, Medical Provider Billing

Effective January 1, 2020 WSI will implement a new Fee Schedule for Long-Term Care Hospital (LTCH) charges. 


Application Downtime 12/8/19

Categories: all, Agency News

All WSI applications will be unavailable from 4:00am until 9:00am on December 8th, 2019 for scheduled upgrades and maintenance. These applications include:

  • myWSI
  • Online Payroll Reporting
  • Online Application for Insurance
  • Incident Report
  • Billing Fee Schedule
  • Claim Lookup
  • Employer Search

How “Leading Indicators” are Used in Safety Management

Categories: all, Safety All News

Leading indicators measure the events leading up to injuries and fatalities, and also provide information about the current state of an organization's safety management system.


Free Learning Saves Policyholders over $13 million

Categories: all, Safety All News, Employer News

Education and training are important tools in safety programs and WSI is proud to offer policyholders a free learning management system (LMS) and OSHA training.  


Check out these new features on myWSI

Categories: all, Agency News, Employer News

Employers can now access their Loss Run reports in myWSI!

Also available on myWSI, employers, workers and medical providers can manage their notifications and alerts. 


Medical Provider Payee Registration Form Required by August 30, 2019

Categories: all, Medical Provider All News, Medical Provider Billing, Medical Provider Pharmacy

WSI recently published an article about the Medical Provider Payee Registration form now being required. If a practice has not yet submitted the required form, you must do so by August 30, 2019, or WSI will deny payment.


Employers Required to File Payroll Online Starting August 1, 2019

Categories: all, Employer News

Starting on August 1, 2019, employers will be required to provide their payroll report online through WSI's Online Services Reporting.


New QuickPay Option for Employers to Pay Their WSI Account

Categories: all, Employer News

With WSI’s QuickPay, employers never have to stop in or send a check to pay premium and assessment fees.


Implementation of Maximum Daily Dosage Limits for Lyrica® (Pregabalin)

Categories: all, Medical Provider All News, Medical Provider Pharmacy

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.


Revised Medical Provider Payee Registration Form Required

Categories: all, Medical Provider All News, Medical Provider Billing, Medical Provider Pharmacy

WSI recently revised the Medical Provider Payee Registration form, which a practice must submit to receive payment from WSI.


Grain Bin Safety – Protect Your Workers

Categories: all, Safety All News

Grain bin safety should be a priority for all farmers and grain handling facilities.


Construction Safety - Actions for Success

Categories: all, Safety All News

A good thing to do first is to define construction safety! 


Follow WSI on Facebook and Twitter

Categories: all, Agency News

Follow us Facebook and Twitter!


Changes Made to Experience Rate Report

Categories: all, Employer News

The Experience Rate Report that is issued prior to renewal for each employer account that qualifies for an Experience Rate has changed.


Announcement of New WSI Medical Director

Categories: all, Medical Provider All News

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.


Sign up today for new Employer Newsletter

Categories: all, Employer News

WSI now has an electronic newsletter for employers, Employer InSite!


Change to Utilization Review Process for Total Knee Arthroplasty

Categories: all, Medical Provider All News, Medical Provider Billing, Medical Provider Utilization Review

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.


Documentation Requirements for Prior Authorization of an Elective Lumbar Fusion

Categories: all, Medical Provider All News, Medical Provider Billing, Medical Provider Utilization Review

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


Reimbursement Requirements for Vision Correction Materials

Categories: all, Medical Provider All News, Medical Provider Billing

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


Change in Billing for Instruction on the Use of a Transcutaneous Neurostimulator (TENS) Unit

Categories: all, Medical Provider All News, Medical Provider Billing, Medical Provider Utilization Review

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.


Updated Fee Schedule effective January 1, 2019

Categories: all, Medical Provider All News, Medical Provider Billing

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


Clarification on Previous Advanced Beneficiary Notice (ABN) Article

Categories: all, Medical Provider All News, Medical Provider Billing, Medical Provider Utilization Review

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.


Advanced Beneficiary Notice (ABN) Form to be Completed for Each Date of Service

Categories: all, Medical Provider All News, Medical Provider Billing, Medical Provider Utilization Review

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


Annual Renewal of Authorization for Brand Necessary Medication

Categories: all, Medical Provider All News, Medical Provider Pharmacy

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


WSI Expands EDI Medical Billing Options through iHCFA

Categories: all, Medical Provider All News, Medical Provider Billing

WSI has expanded the EDI billing options available through iHCFA to include facility charges (UB-04/837i).


Diagnosis Coding for Injured Worker Treatment Encounters

Categories: all, Medical Provider All News, Medical Provider Billing

To establish claim and medical bill liability, WSI requires a provider submit a specific diagnosis code reflective of the injury treated. This requirement aligns with General Coding Guidelines (4) and (18), published in the ICD-10-CM Official Guidelines for Coding and Reporting.


New Documentation Requirements for Prior Authorization of Therapeutic Injections Policy

Categories: all, Medical Provider All News, Medical Provider Billing, Medical Provider Utilization Review

Change to Chiropractic Window Period

Categories: all, Medical Provider All News, Medical Provider Billing, Medical Provider Utilization Review

Effective October 1, 2018, WSI will implement a change to the window period allowed in the existing chiropractic pilot program.


Prior Authorization Required for Non-Emergent Air Transportation Services

Categories: all, Medical Provider All News, Medical Provider Billing, Medical Provider Utilization Review

Effective September 1, 2018, WSI will require prior authorization for non-emergent air transportation services, see North Dakota Administrative Code § 92-01-02-34.5(e).


Introduction of Cordant Health Solutions for Chronic Opioid Monitoring

Categories: all, Medical Provider All News, Medical Provider Billing

WSI recently partnered with Cordant Health Solutions to assist in the coordination of medication monitoring for injured workers on chronic opioid therapy.


WSI’s Expectations for Presumptive Drug Screens and Definitive Drug Testing

Categories: Medical Provider News Archive

WSI has expectations for presumptive drug screening and definitive testing, based on adopted medical guidelines. Reimbursement for these drug tests is dependent upon a provider’s compliance with these expectations.


Services not Reimbursable by WSI

Categories: Medical Provider News Archive

WSI does not provide reimbursement for services considered unnecessary to treat or diagnose a compensable work injury.  This includes services generally considered preventive. 


Introduction of Window Period into Chiropractic Pilot Program

Categories: Medical Provider News Archive

Effective January 1, 2018, WSI will implement a change to the chiropractic pilot program. 


Options for Submitting a Prior Authorization Request for Medication

Categories: Medical Provider News Archive

WSI offers several options for submitting a request for medications, which require prior authorization.


Updated Fee Schedule effective January 1, 2018

Categories: Medical Provider News Archive

Effective January 1, 2018, WSI will implement the following fee schedule changes.  Click here to access the full fee schedules. 


Provider Remittance Advice Revised

Categories: Medical Provider News Archive

Effective November 29, 2017, WSI will begin issuing a revised Remittance Advice to medical providers.


New Cotinine Testing Requirements for Elective Cervical and Lumbar Fusion Surgeries

Categories: Medical Provider News Archive

Effective November 1, 2017 WSI will require documentation of a negative cotinine level at both six weeks and one week prior to an elective cervical or lumbar fusion surgery scheduled for an injured worker.


Discontinuation of Questionnaire Forms for Elective Lumbar Fusion Surgery

Categories: Medical Provider News Archive

Effective November 1, 2017, WSI will discontinue the requirement for a provider to submit the Pain Questionnaire and Surgery Expectation Questionnaire forms as part of the prior authorization process for an elective lumbar fusion.


Changes Regarding Prior Authorization Review Requests

Categories: Medical Provider News Archive

Effective August 1, 2017, WSI will implement changes involving prior authorization review requests.


Outpatient Hospital Fee Schedule Payment Methodology Change

Categories: Medical Provider News Archive

Effective July 1, 2017 WSI will implement the use of the 3M Ambulatory Payment Classification (APC) grouper.


Clarifications for Providing Chiropractic Treatment

Categories: Medical Provider News Archive

Based on provider feedback, WSI has outlined some points of clarification for providing chiropractic treatment to an injured worker.


Adoption of CPT® Guidelines for Telemedicine Services

Categories: Medical Provider News Archive

WSI has adopted the AMA’s CPT® Guidelines for telemedicine services. Telemedicine seeks to improve a patient's health by permitting two-way, real time interactive communication between the patient and a physician or practitioner at a distant site.


Updated Fee Schedule Effective January 1, 2017

Categories: Medical Provider News Archive

Effective January 1, 2017, WSI will implement the following fee schedule changes.  Click here to access the full fee schedules. 


Change to Chiropractic Prior Authorization Requirements

Categories: Medical Provider News Archive

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.


Changes in Billing for Drugs of Abuse Testing Codes

Categories: Medical Provider News Archive

Effective for dates of service in 2016, WSI adopted new CMS standards regarding billing for drugs of abuse. 


Updated Fee Schedule Effective January 1, 2016

Categories: Medical Provider News Archive

Effective January 1, 2016, WSI implemented the following fee schedule changes.   


Change to the UR Process for Speech Therapy Effective March 1, 2016

Categories: Medical Provider News Archive

Effective March 1, 2016, WSI will require prior authorization of speech therapy by the Utilization Review (UR) department.


Massage Therapy Coverage Changes Effective March 1, 2016

Categories: Medical Provider News Archive

Effective March 1, 2016, WSI will implement changes regarding the coverage of massage therapy treatment.


2016 Outpatient Laboratory Status Indicator and Billing Changes

Categories: Medical Provider News Archive

Changes to Fee Schedule Guidelines

Categories: Medical Provider News Archive

WSI has restructured the Fee Schedule Guidelines, offering a more user-friendly product for 2016.


New Procedure Implemented for Billing of a Bilateral Procedure

Categories: Medical Provider News Archive

WSI recently changed the standard for billing a unilateral procedure performed bilaterally in order to align with CMS.


Change in Bill Processing of Miscellaneous DMEPOS Codes

Categories: Medical Provider News Archive

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. 


HCPCS Temporary National Codes are Not Reimbursed

Categories: Medical Provider News Archive

Effective for dates of service beginning September 1, 2015, WSI will not reimburse for procedures billed with HCPCS Temporary National Codes (T Codes).


ICD-10 Implementation Update

Categories: Medical Provider News Archive

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.


Statute Amended Regarding Healthcare Provider Disclosure of Information to WSI

Categories: Medical Provider News Archive

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.


Changes in Billing for Drugs of Abuse Testing Codes

Categories: Medical Provider News Archive

This article highlights significant changes in billing for drugs of abuse testing codes in the Clinical Laboratory Fee Schedule.


Prior Authorization Required for Long-Acting Opioid Medication

Categories: Medical Provider News Archive

Effective February 1, 2015, WSI will require prior authorization of long-acting opioid medication.


Updated Fee Schedule effective January 1, 2015

Categories: Medical Provider News Archive

Effective January 1, 2015, WSI will implement the following fee schedule changes. Click here to access the full fee schedules.


Inpatient Billing Requires Primary Diagnosis Code

Categories: Medical Provider News Archive

Effective January 1, 2015, WSI will require the primary diagnosis code for an inpatient hospital charge.


Red and White Forms Required for Medical Billing

Categories: Medical Provider News Archive

Effective January 1, 2015 WSI will adopt CMS guidelines, which require red and white versions of the CMS 1500 and UB-04.


2014 Billing Outpatient Lab Charges

Categories: Medical Provider News Archive

This article highlights a significant change in billing of lab work provided in the outpatient hospital setting.


Evaluation & Management Documentation

Categories: Medical Provider News Archive

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.


H-wave Electrical Stimulation Not Covered

Categories: Medical Provider News Archive

WSI does not cover H-wave electrical stimulation, as it is investigational and experimental.


Billing WSI when Medicare is the Secondary Payer

Categories: Medical Provider News Archive

WSI has identified healthcare providers billing services to Medicare when WSI is the primary payer.


Billing of Hearing Aids and Related Services

Categories: Medical Provider News Archive

The following information provides clarification on reimbursement and prior authorization for hearing aids and associated services.


Revised Workability Assessment Program Criteria

Categories: Medical Provider News Archive

In January 2013, WSI issued a Provider Bulletin detailing criteria for the workability assessment program. Based on provider feedback, the following are new criteria for a workability assessment with dates of service after January 1, 2014.


Continuous-flow Cryotherapy Units No Longer Covered

Categories: Medical Provider News Archive

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.


Bloodborne Pathogen Exposure Claims

Categories: Medical Provider News Archive

Bloodborne pathogen exposure claims need to be billed with modifier 22 added to the charges for the source patient.