Drug Coverage Policies
Below is a list of policies relating to drug coverage, including limitations, criteria for coverage and treatment guidelines.
| Covered by workers comp? | ||||
| For more information, select the link below or call the Preferred Drug List Hotline at 1-888-443-6798. | Yes | No | ||
| With proper documentation | Only with pre-authorization | On a case-by-case basis | ||
| Antiepileptic drugs (AEDs) for neuropathic pain | X drug limitations | |||
| Benzodiazepines, see WAC 296-20-03014(4) | X time limitations | |||
| Botulinum toxin | X | |||
| Buprenorphine products | X |
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| Buprenorphine (Butrans) Transdermal System | X |
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| Compounded drug products | X |
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| Carisoprodol products | X | |||
| Duloxetine for chronic musculoskeletal pain (Effective March 1, 2013) | X | |||
| Fentanyl transmucosal products | X | |||
| Fentanyl transdermal products (Duragesic ®) | X | |||
| Hyaluronic acid | X | |||
| Local anesthetics - Lidocaine patch (Lidoderm ®) and lidocaine / prilocaine cream (EMLA ®) | X | |||
| Medical food or "co-pack" products | X | |||
| Post-exposure Prophylaxis (PEP) | X | |||
| Propanolol for anxiety symptoms (Effective March 1, 2013) | X | |||
| Opioids for non-cancer pain | X | |||
| Sedative-hypnotics | X time limitations | |||
| Smoking cessation products | X | |||
| Tramadol products | X | |||
