Provider Newsletter - April 2013

Provider News

This is a periodic roundup of L&I news for medical providers. To subscribe by email, join our Medical Provider News email list.

You can also read previous Provider News editions.

In the Provider News for April 2013:

L&I's new opioid guideline includes a state-of the-art section on managing surgical pain

Image of Opioid Guidelines
In January we announced L&I’s new Guideline for Prescribing Opioids to Treat Pain in Injured Workers, effective July 1. The new guideline provides valuable information to help you improve treatment, including an important section on managing surgical pain in workers on chronic opioid therapy (COT). 

Patients on COT often report more pain and experience a lot of anxiety — and when they undergo surgery, they experience more frequent and more deadly respiratory depressive episodes than opioid-naïve patients.

To help you manage the worker’s pain and minimize surgical risks, this section gives you the elements of a coordinated treatment plan and recommends specific actions, such as:

  • Prior to surgery, access the state’s prescription monitoring program and review the worker’s controlled substance history to get accurate information on opioid dose and concurrent medication use.
  • On the day of surgery, consider the use of non-opioid analgesic adjuvants for opioid-sparing effects.
  • After surgery, prescribe only short-acting opioids for post-operative pain to supplement the worker’s pre-operative opioid regimen. In most cases, opioids should be tapered to pre-operative dose or lower by 6 weeks after surgery.

This guideline was developed by practicing physicians who specialize in treating injured workers and in pain management. They are part of the Industrial Insurance Medical Advisory Committee (IIMAC) and its subcommittee on chronic non-cancer pain.  The guideline reflects the best available clinical and scientific evidence and a consensus of expert opinion.

We encourage you to review the guideline and adopt its best practices now. This will give you a head start on incorporating new requirements into your practice before the July 1 effective date.  The best practices will be familiar from the Agency Medical Directors’ guideline (2010) and the Department of Health’s pain management rules implemented in 2011–2012. 

New opioid rules comment period extended to April 26 at 12 p.m.

L&I has extended the public comment period on proposed new rules that implement the agency’s new opioid treatment guideline.  All comments must now be received by 12 p.m. April 26.

Written comments may be sent by mail to Jami Lifka, Department of Labor & Industries, PO Box 44321, Olympia, WA  98504-4321; by e-mail to; or faxed to 360-902-6315.

Additional background is available in our news release.

Network providers a tip for billing self-insurers

When billing self-insured employers, always include your individual NPI number rather than relying on your L&I Provider ID number or a facility NPI.  On the CMS 1500 bill form, enter your individual NPI number in box 24 J.  The self-insurer identifies network providers through their individual NPIs. If your network status can’t be confirmed, they are likely to deny your bills for treating injured workers.

Beware of phishing attempts

Recently we received 3 reports from providers’ offices concerned about callers asking for workers’ comp-related information.  Private companies may call you on our behalf, but they will never ask you to give banking or similar information over the phone.  Nor will L&I staff. No matter how convincing a caller sounds, never tell them your bank account number.

In addition, when you fax forms with private information to L&I, be sure that you are using an L&I fax number - you can check it by going to and entering the number in the Search box.

If you may have been the victim of a scam, here are some tips about what to do next from the Federal Trade Commission.

We're looking for consultants for file reviews on open claims

L&I has published a request for medical consultants to provide file reviews on open claims for injured workers and crime victims.  This request is not for IMEs or examinations.  We are seeking clinicians in oncology, oral surgery, CRI occupational medicine, psychiatry, occupational medicine, orthopedics, neurology, ophthalmology, internal medicine, podiatry, physiatry, chiropractic, ENT, dental, and physical therapy.

We do not guarantee a minimum number of consulting hours, but we expect the volume to range from 5 to 20 hours per month per contractor, depending on the specialty.  The exception is physical therapy, which could involve 80+ hours of consultation each month.

The request is posted at Washington's Electronic Business Solutions (WEBS) as RFQQ K2730. Responses are due May 10, 2013. If you’re just now registering for WEBS, you will need to search for this posting.  To receive future RFQQs or RFPs from L&I, register using commodity code 948-74.

Questions? Contact Christine Cook at 360-902-5024.

We have contracted with medical experts to advise attending physicians on patient care since 1985. Consultations with medical experts are essential to the care of injured workers and crime victims. They are also necessary for decision-making on workers compensation claims. 

Register for a webinar on online filing and Stay at Work

You can help injured workers with their recovery by filing their accident reports online and by encouraging their employers to participate in the Stay at Work program.  To learn how these strategies might work in your office, register for one of our register for one of our webinars.

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