Safety News

Program builds upon ‘Back the Blue’ legislation signed last spring

WSI has updated the Medical Bill Appeal (M6) form. The changes aim to simplify completion of the form and offer guidance on what documentation a provider should submit for common reason codes.

Due to system maintenance, WSI systems and online applications, including myWSI, will be unavailable starting at 1:00 p.m. on Friday, August 4 until 8:00 a.m. on Monday, August 7.

The following guidelines are intended to provide guidance as to who is covered by North Dakota Workforce Safety & Insurance (WSI) worker’s compensation coverage, and when they are covered or not covered during times of disaster, including spring flooding.

Effective January 1, 2023, WSI has adopted Medicare’s new ASC payment policy for OPPS complexity adjusted C-APCs.

Did you know WSI provides a Claim Lookup application?

WSI recently published a new documentation policy, Evaluation and Management Services.

Workforce Safety and Insurance previously published an article about transitioning to a new pharmacy benefit manager, Integrated Prescription Management (IPM). This article provides additional information on submitting pharmacy charges through IPM.

Effective January 1, 2023, WSI will implement the following fee schedule changes.

Workforce Safety and Insurance previously published an article about a transition to FourStone Partners for the coordination of medication monitoring for injured employees on chronic opioid therapy.  After receiving several follow-up questions from providers about the article, WSI is providing further clarification.

By the end of 2022, WSI will be transitioning from Envolve to a new pharmacy benefit manager, Integrated Prescription Management (IPM).

WSI was a victim of a cyber security attack on June 28, 2022, which involved personal data.

Since 2018 WSI has partnered with Cordant Health Solutions to assist in the coordination of medication monitoring for injured employees on chronic opioid therapy. Currently, Cordant Health Solutions is transitioning to FourStone Partners. 

US Department of Labor reminds Great Lakes region's employers that workers need protection from dangers of heat illness: indoors, outdoors

WSI requires a provider to report the most specific diagnosis code reflective of the injury treated instead of using the standalone diagnosis code of “pain”.

In response to several provider questions, WSI is providing clarification on the billing requirements for a service completed by a Physical Therapist Assistant (PTA) or Occupational Therapist Assistant (OTA).  

Effective January 1, 2022, WSI will implement the following fee schedule changes. Click here to access the full fee schedules. 

The 2021 North Dakota Legislative Assembly enacted changes to North Dakota Administrative Code pertaining to WSI’s prior authorization review of palliative care. 

Effective January 1, 2022, WSI will deny medical bills received in paper format from a practice that submits at least 50 bills per calendar year.

WSI is launching a new Phase III of the Ergonomic Initiative Grant on Oct. 21, 2021.

WSI has made available several resources to assist providers in their compliance with the recent requirement to submit medical bills through Electronic Data Interchange (EDI). 

The 2021 North Dakota Legislative Assembly enacted a change to North Dakota Century Code §65-01-02(21) adding physical therapist to the definition of health care provider. 

WSI now offers electronic fund transfers (EFT) as a means of payment to a medical provider for a rendered service. 

WSI recently launched an all new and easier than ever to use Payroll Reporting application for employers.

The 2021 North Dakota Legislative Assembly enacted North Dakota Century Code §65-05-40, to address quantity and duration limits for opioid and benzodiazepine therapies.

Effective tomorrow, July 1st, 2021, WSI will accept medical bills solely through Electronic Data Interchange (EDI).

WSI recently published an article about a change being made to the policies, Outpatient E/M Services and Other E/M Services, regarding reimbursement.

Effective July 1, 2021, WSI will accept medical bills solely through Electronic Data Interchange (EDI).

Effective May 19^th, 2021, WSI will make a change to the policies, Outpatient E/M Services and Other E/M Services, regarding reimbursement.

WSI recently published two new documentation policies, Outpatient E/M Services and Other E/M Services.

WSI has posted the 2021 Fee Schedule files to the online WSI Fee Schedule.

Effective January 1, 2021, WSI will implement the following fee schedule changes.  Click here to access the full fee schedules. 

WSI will be implementing an EDI billing requirement effective July 1, 2021.

WSI recently enhanced the Utilization Review (UR) application in MyWSI.

Effective for dates of service on or after July 1, 2020, WSI will reinstate the previous timeframe of 30 days to appeal a medical bill or utilization review decision, and 90 days to complete an approved surgery. 

With the recent information regarding COVID-19, WSI is opening the lobby to the public beginning Monday, June 22, 2020.

WSI has created how-to videos to assist employers when using myWSI.

WSI billing requirements for home health care include both a per hour and/or a per visit reimbursement rate.

WSI’s Application for Insurance must be completed online beginning April 30, 2020.

WSI is temporarily extending the acceptable filing timeframe for appealing a previously reduced or denied medical bill.

Governor Burgum amends executive order extending workers' compensation coverage for COVID-19 for funeral service personnel.

WSI Invites Medical Providers to Sign-Up for myWSI.

COVID-19 FAQS for Medical Providers

To prevent the spread of COVID-19, the public hearing on premium rates scheduled for April 6, 2020, will held via conference call.

WSI has created a FAQs document to assist with questions regarding the extended coverage for COVID-19 for frontline health care workers and first responders and general workers' compensation claim information.

WSI previously published an article about expanding eligible telemedicine services due to COVID-19.  After receiving several follow-up questions from providers, WSI is providing clarification on the types of telemedicine services and billing codes allowed for the duration of the emergency declaration.

Governor Doug Burgum today announced an executive order easing reporting requirements for employers.

Governor Doug Burgum issues executive order for extending workers’ compensation coverage for COVID-19 to first responders and frontline health care workers.

In response to the COVID-19 pandemic, WSI has made changes to business practices involving medical services.

Effective March 20, 2020, WSI is temporarily expanding eligible telehealth services in response to Governor Burgum’s Executive Order 2020-05.1 and in alignment with CMS guidelines.

Due to public health concerns, WSI's office in Bismarck is closed to the public.

WSI has created a new Remittance Advice Reason Code, 243, to address non-authentic medical documentation.

The following guidelines are intended to provide guidance as to who is covered by WSI worker’s compensation coverage, and when they are covered or not covered during times of disaster including spring flooding. 

WSI has posted the 2020 Fee Schedule files to the online WSI Fee Schedule.

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.

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

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.

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.  

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. 

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.

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

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

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

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.

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

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

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

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.

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

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.

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

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.

WSI recently published a new medical policy, Documentation Requirements for Prior Authorization of Therapeutic Injections. 

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

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).

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

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.

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

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

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

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

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

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.

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.

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

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

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

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.

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

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.

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

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

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

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

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

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

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. 

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

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.

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.

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

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

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

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

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

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

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.

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

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

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

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.

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 need to be billed with modifier 22 added to the charges for the source patient.