Medical Aid Rules |
WAC Sections |
| 296-20-010 |
General information |
| 296-20-0100 |
Chiropractic advisory committee |
| 296-20-01001 |
Medical advisory industrial insurance committee |
| 296-20-01002 |
Definitions |
| 296-20-015 |
Who may treat |
| 296-20-01501 |
Physician's assistant rules |
| 296-20-01505 |
Provider types and services not covered |
| 296-20-020 |
Acceptance of rules and fees |
| 296-20-02005 |
Keeping of records |
| 296-20-02010 |
Review of health services providers |
| 296-20-02015 |
Interest on excess payments |
| 296-20-022 |
Payment of out-of-state providers |
| 296-20-023 |
Third party settlement -- Excess recoveries |
| 296-20-024 |
Utilization management |
| 296-20-025 |
Initial treatment and report of accident |
| 296-20-02700 |
What is a medical coverage decision? |
| 296-20-02701 |
Who makes medical coverage decisions? |
| 296-20-02702 |
Who uses medical coverage decisions? |
| 296-20-02703 |
How can I determine if a specific health care service or supply is the subject of a medical coverage decision? |
| 296-20-02704 |
What criteria does the director or director's designee use to make medical coverage decisions? |
| 296-20-02705 |
What are treatment and diagnostic guidelines and how are they related to medical coverage decisions? |
| 296-20-02850 |
When may the department cover controversial, obsolete, investigational or experimental treatment?
Back to top |
| 296-20-030 |
Treatment not requiring authorization for accepted conditions |
| 296-20-03001 |
Treatment requiring authorization |
| 296-20-03002 |
Treatment not authorized |
| 296-20-03004 |
Chemonucleolysis |
| 296-20-03005 |
Inoculation or immunological treatment for exposure to infectious occupational disease |
| 296-20-03010 |
What are the general principles the department uses to determine coverage on drugs and medications? |
| 296-20-03011 |
What general limitations are in place for medications? |
| 296-20-03012 |
Where can I find the department's outpatient drug and medication coverage decisions? |
| 296-20-03013 |
Will the department or self-insurer pay for a denied outpatient drug in special circumstances? |
| 296-20-03014 |
Which drugs have specific limitations? |
| 296-20-03015 |
What steps may the department or self-insurer take when concerned about the amount or appropriateness of drugs and medications prescribed to the injured worker? |
| 296-20-03016 |
Is detoxification and/or chemical dependency treatment covered? |
| 296-20-03017 |
What information is needed for prescriptions and the physician's record? |
| 296-20-03018 |
What inpatient drugs are covered? |
| 296-20-03019 |
Under what conditions will the department or self-insurer pay for oral opioid treatment for chronic, noncancer pain? |
| 296-20-03020 |
What are the authorization requirements for treatment of chronic, noncancer pain with opioids? |
| 296-20-03021 |
What documentation is required to be submitted for continued coverage of opioids to treat chronic, noncancer pain? |
| 296-20-03022 |
How long will the department or self-insurer continue to pay for opioids to treat chronic, noncancer pain? |
| 296-20-03023 |
When may the department or self-insurer deny payment of opioid medications used to treat chronic, noncancer pain? |
| 296-20-03024 |
Will the department or self-insurer pay for nonopioid medications for the treatment of chronic, noncancer pain? |
| 296-20-035 |
Treatment in cases that remain open beyond sixty days |
| 296-20-045 |
Consultation requirements
Back to top |
| 296-20-051 |
Consultations |
| 296-20-055 |
Limitation of treatment and temporary treatment of unrelated conditions when retarding recovery |
| 296-20-06101 |
What reports are health care providers required to submit to the insurer? |
| 296-20-065 |
Transfer of doctors |
| 296-20-071 |
Concurrent treatment |
| 296-20-075 |
Hospitalization |
| 296-20-081 |
Unrelated concurrent nonemergent surgery |
| 296-20-091 |
Home nursing |
| 296-20-097 |
Reopenings |
| 296-20-09701 |
Request for reconsideration |
| 296-20-100 |
Eye glasses and refractions |
| 296-20-110 |
Dental |
| 296-20-1101 |
Hearing aids and masking devices |
| 296-20-1102 |
Special equipment rental and purchase prosthetic and orthotics equipment |
| 296-20-1103 |
Travel expense |
| 296-20-120 |
Procedures not listed in this schedule |
| 296-20-12050 |
Special programs |
| 296-20-12055 |
Structured intensive multidisciplinary program (SIMP) for chronic noncancer pain |
| 296-20-12060 |
SIMP requirements for lumbar fusion and artificial disc replacement candidates. |
| 296-20-12065 |
SIMP definitions. |
| 296-20-12070 |
SIMP evaluation phase. |
| 296-20-12075 |
SIMP treatment phase. |
| 296-20-12080 |
SIMP follow up phase. |
| 296-20-12085 |
Requirements the SIMP provider must meet. |
| 296-20-12090 |
Requirements the worker must meet for a SIMP. |
| 296-20-12095 |
SIMP referral and prior authorization requirements. |
| 296-20-121 |
X-rays |
| 296-20-124 |
Rejected and closed claims |
| 296-20-12401 |
Provider application process |
| 296-20-125 |
Billing procedures |
| 296-20-12501 |
Physician assistant billing procedure |
| 296-20-132 |
Determination of conversion factor adjustments |
| 296-20-135 |
Conversion factors |
| 296-20-170 |
Pharmacy -- Acceptance of rules and fees |
| 296-20-17001 |
Allowance and payment for medication |
| 296-20-17002 |
Billing |
| 296-20-17004 |
Billing and payment for initial prescription drugs. |
| 296-20-19000 |
What is a permanent partial disability award?
Back to top |
| 296-20-19010 |
Are there different types of permanent partial disabilities? |
| 296-20-19020 |
How is it determined which impairment rating system is to be used to rate specified and unspecified disabilities? |
| 296-20-19030 |
To what extent is pain considered in an award for permanent partial disability? |
| 296-20-200 |
General information for impairment rating examinations by attending doctors, consultants or independent medical examination (IME) providers. |
| 296-20-2010 |
General rules for impairment rating examinations by attending doctors and consultants |
| 296-20-2015 |
What rating systems are used for determining an impairment rating conducted by the attending doctor or a consultant? |
| 296-20-2025 |
May a worker bring someone with them to an impairment rating examination conducted by the attending doctor or a consultant? |
| 296-20-2030 |
May the worker videotape or audiotape the impairment rating examination conducted by the attending doctor or a consultant? |
| 296-20-220 |
Special rules for evaluation of permanent bodily impairment |
| 296-20-230 |
Cervical and cervico-dorsal impairments |
| 296-20-240 |
Categories of permanent cervical and cervico-dorsal impairments |
| 296-20-250 |
Impairments of the dorsal area |
| 296-20-260 |
Categories of permanent dorsal area impairments |
| 296-20-270 |
Dorso-lumbar and lumbosacral impairments |
| 296-20-280 |
Categories of permanent dorso-lumbar and lumbosacral impairments |
| 296-20-290 |
Impairments of the pelvis |
| 296-20-300 |
Categories of permanent impairments of the pelvis |
| 296-20-310 |
Convulsive neurological impairments |
| 296-20-320 |
Categories of permanent convulsive neurological impairments |
| 296-20-330 |
Impairments of mental health |
| 296-20-340 |
Categories for evaluation of permanent impairments of mental health |
| 296-20-350 |
Cardiac impairments |
| 296-20-360 |
Categories of permanent cardiac impairments |
| 296-20-370 |
Respiratory impairments |
| 296-20-380 |
Categories of permanent respiratory impairments |
| 296-20-385 |
Categories of persisting variable respiratory impairment with normal baseline spirometry |
| 296-20-390 |
Air passage impairments |
| 296-20-400 |
Categories of permanent air passage impairments |
| 296-20-410 |
Nasal septum impairments |
| 296-20-420 |
Categories of permanent air passage impairment due to nasal septum perforations
Back to top |
| 296-20-430 |
Loss of taste and smell |
| 296-20-440 |
Categories of permanent loss of taste and smell |
| 296-20-450 |
Speech impairments |
| 296-20-460 |
Categories of permanent speech impairments |
| 296-20-470 |
Skin impairments |
| 296-20-480 |
Categories of permanent skin impairments |
| 296-20-490 |
Impairment of the upper digestive tract, stomach, esophagus or pancreas |
| 296-20-500 |
Categories of permanent impairments of the upper digestive tract, stomach, esophagus or pancreas |
| 296-20-510 |
Lower digestive tract impairments |
| 296-20-520 |
Categories of permanent lower digestive tract impairments |
| 296-20-530 |
Impairment of anal function |
| 296-20-540 |
Categories of permanent impairments of anal function |
| 296-20-550 |
Liver and biliary tract impairments |
| 296-20-560 |
Categories of permanent liver and biliary tract impairments |
| 296-20-570 |
Impairments of the spleen, loss of one kidney, and surgical removal of the bladder with urinary diversion |
| 296-20-580 |
Categories of permanent impairment of the spleen, loss of one kidney, and surgical removal of bladder with urinary diversion |
| 296-20-590 |
Impairment of upper urinary tract |
| 296-20-600 |
Categories of permanent impairments of upper urinary tract |
| 296-20-610 |
Additional permanent impairments of upper urinary tract due to surgical diversion |
| 296-20-620 |
Categories of additional permanent impairments of upper urinary tract due to surgical diversion |
| 296-20-630 |
Impairment of bladder function |
| 296-20-640 |
Categories of permanent impairments of bladder function |
| 296-20-650 |
Anatomical or functional loss of testes |
| 296-20-660 |
Categories of permanent anatomical or functional loss of testes |
| 296-20-670 |
Disability |
| 296-20-680 |
Classification of disabilities in proportion to total bodily impairment |
| 296-20-690 |
Permanent impairments of the cervico-dorsal (WAC 296-20-240) and lumbosacral regions (WAC 296-20-280) jointly |
