If you have any questions or need additional information, please call Carmen Moore at (360) 902-4206.

Provider Bulletin 04-06: Coverage Decision (November 2003 to March 2004)

Provider Bulletin 04-06 describes policies currently in effect for State Fund and Self-Insurance claims in all locations: Noncoverage of Electrodiagnostic Sensory Nerve Conduction Threshold Testing; Noncoverage of Extracorporeal Shockwave Therapy; Noncoverage of Percutaneous Discectomy for Disc Herniation; Noncoverage of Percutaneous Neuromodulation Therapy (PNT); and Coverage of MedX Lumbar Extension Machine. This policy was issued May 2004.

Contact Grace Wang, mailstop 4321, phone (360) 902-5227.

Autologous Blood Injections

Autologous blood injection/patch therapy is not a covered therapy at this time for lateral epicondylitis or any other indication. Autologous blood injections are intended to treat lateral epicondylitis, or "tennis elbow." It has been hypothesized that blood injections contain the cellular and humoral mediators to induce a healing cascade. Autologous blood injections are considered experimental at this time due to a lack of published literature indicating safety and effectiveness. This is a different therapy from the epidural blood patch used for spinal leaks; the epidural blood patch is still a covered therapy. This new policy is effective June 25, 2004.

Contact Molly Belozer, mailstop 4312, phone (360) 902-5026.

Powered Traction Devices for Intervertebral Decompression

This coverage decision memo updates the VAX-D policy as communicated in Provider Bulletin 00-09. This decision applies to all FDA approved powered traction devices. When powered traction is a proper and necessary treatment, the department or self-insured employer may pay for powered traction therapy administered by a licensed practitioner. Indications for use of powered traction tables are limited to patients that have demonstrable presence of disc protrusion or nerve root entrapment. Contraindications include: Spondylolisthesis or spondylolysis, infection, neoplasm, osteoporosis, bilateral pars defect, fractures, surgical hardware in the spine, caudal equina syndrome, and lateral or central stenosis with severe secondary changes. Published literature has not substantially shown whether powered traction devices are more effective than other forms of traction, other conservative treatments, or surgery. For billing and payment purposes, CPT 97012 is used for the provision of powered traction therapy. Only one unit of this code will be paid per visit, regardless of the length of time traction is applied. The department will not pay any additional cost when powered traction devices are used. This policy was amended June 25, 2004.

Contact Grace Wang, mailstop 4321, phone (360) 902-5227.

Tinnitus Retraining Therapy

Tinnitus Retraining Therapy for tinnitus is a noncovered service at this time because it is considered investigational and controversial.

Tinnitus Retraining Therapy (TRT) is a program intended to address and treat chronic tinnitus. TRT is based on a neurophysiological model and aims to allow a patient to habituate to the tinnitus signal by modifying the neural connections linking the auditory with the limbic and autonomic nervous systems.

TRT is considered investigational and controversial due to the lack of evidence addressing effectiveness. No prospective studies with comparison groups have been published to evaluate TRT for chronic tinnitus. As a result, the efficacy of TRT for tinnitus has not been established.

In addition, published criticism of TRT suggests that TRT is not fundamentally different from cognitive therapy. TRT has also been criticized for not involving trained psychologists and for not using validated diagnostic and evaluation instruments. This policy was amended June 25, 2004.

Contact Grace Wang, mailstop 4321, phone (360) 902-5227.

INTERIM POLICY 63.70 Revoked Accounts With Current Employees

This policy provides department staff with guidelines needed when notified that an employer with a revoked Certificate of Coverage has workers. This new policy is effective June 4, 2004.

Contact Linda Norris, mailstop 4310, phone (360) 902-4999.

Specialty Compliance Services Division

ES.D.2 Record Keeping and access to Payroll Records-Agricultural Employment

This policy provides the department's interpretation of the state's record-keeping regulations for agricultural workers under the Agricultural Labor Act, chapter 49.30 RCW and chapter 296-131 WAC. This policy was amended to include a policy on rounding practices when employers use time clocks or written records keeping systems that clearly show the time the employee clocks in or checks in for work at beginning and end of their shift. This policy was amended May 7, 2004.

Process for objections to apprenticeship program standards, 03-01.

This policy clarified the apprenticeship program standard process. This policy was issued on October 17, 2003 and will now be repealed from policy and included in WAC 296-05-008, effective June 1, 2004.

Contact Christine Swanson, mailstop 4400, phone (360) 902-6411.

WISHA Services Division

WISHA Regional Directive (WRD) 7.06, "Use of Powered Industrial Truck Load Engaging Means to Reduce Awkward Lifting"

WISHA Regional Directive (WRD) 7.06, "Use of Powered Industrial Truck Load Engaging Means to Reduce Awkward Lifting," which will remain in effect indefinitely, provides guidance to WISHA enforcement and consultation staff in applying the requirements of the Powered Industrial Truck Operations Standard when the operator of the truck has dismounted to transfer loads by hand with the load engaging means raised. This new policy is effective May 14, 2004.

Contact Marcia Benn, mailstop 44648, phone (360) 902-5503.

WISHA Regional Directive (WRD) 27.25, "Operating Dump Trucks in Reverse"

WISHA Regional Directive (WRD) 27.25, "Operating Dump Trucks in Reverse," provides guidance to WISHA enforcement and consultation staff initiating inspections on construction sites where dump trucks are operating. It replaces all other instructions on this issue, whether form [formal] or informal. This new policy is effective May 12, 2004.

Contact Marcia Benn, mailstop 44648, phone (360) 902-5503.

Carmen Moore

Legislative and

Governmental Affairs Office

© Washington State Code Reviser's Office