WSR 10-11-108

INTERPRETIVE AND POLICY STATEMENT

DEPARTMENT OF

LABOR AND INDUSTRIES

[ Filed May 18, 2010, 12:08 p.m. ]

In accordance with RCW 34.05.230(12), following is a policy and interpretive statement issued by the department regarding the insurance services division policies.

If you have any questions or need additional information please call Naomi Goodman at (360) 902-4211.


Insurance Services: Office of the medical director, state fund claims administration, self-insurance and crime victims.

New Policy: Provider Bulletin 10-03 Advanced Imaging Utilization Review.

In 2009, the Washington legislature passed ESHB 2105, which directed the state to convene an advanced imaging management work group to identify evidence-based best practice guidelines for advanced imaging. State agencies were directed to implement the work group recommendations. This bulletin announces the implementation of the recommendations.

The bulletin provides guidelines and utilization review for advanced imaging studies. Beginning June 1, 2010, the department of labor and industries will implement evidence-based guidelines for MRI scans of the spine and upper and lower extremities; and CT and MRI scans for headaches. These require prior authorization. For state fund claims, prior authorization must go through the department's contracted utilization firm. Requests for advanced imaging for crime victims' claims go through labor and industries' crime victims' compensation program. Requests for advance[d] imaging for self-insured claims go through the self-insured employer or third party administrator. Labor and industries will pilot an expedited review program for advanced imaging studies with organizations that meet certain criteria.

Contact: Josh Morse, P.O. Box 44321, Olympia, WA 98504-4321, phone (360) 902-5026, e-mail mojo235@lni.wa.gov.

Washington State Code Reviser's Office