We want to thank you for your willingness to continue dispensing medications to workers during the disruption, and we invite you to now re-submit those bills for reimbursement. Pharmacies may override:
- Refill-too-soon and DUR edits (drug-drug interaction, high dose and therapeutic duplication). Please see override codes on pages 5 and 7, respectively, of the NCPDP Payer Sheet for the State Fund.
- First fill prescriptions that reject due to non-preferred status with DAW=6 as long as the days’ supply is 10 or less.
For additional billing questions and issues, pharmacies may contact the PDL Hotline at 888-443-6798.
Pharmacy Services
L&I covers outpatient drugs prescribed to treat industrial injuries or disease. Coverage is based on evidence of drug safety, efficacy and cost. Most drugs that are commonly used for work-related injuries are included on the formulary. Pharmacies can submit drug bills electronically using L&I’s point-of-sale billing system. For general prescription coverage and billing questions, refer to the resources below or call the Preferred Drug List Hotline at 888-443-6798 or 360-902-4321 Monday – Friday, 8 am to 5 pm.