INTERPRETIVE AND POLICY STATEMENT
LABOR AND INDUSTRIES
If you have any questions or need additional information, please call Carmen Moore at (360) 902-4206.
Provider Bulletin 03-09 Coverage Decisions, January 2003 - June 2003
Provider Bulletin 03-09 describes three medical coverage decisions from the Office of the Medical Director.
1. Noncoverage of the ERMI Flexionater and Extensionater Devices
The Flexionater and Extensionater are devices used to address joint stiffness after injury or surgery. They intend to increase range of motion by using patient-controlled load to the joint of concern.
The Flexionater and Extensionater are not covered devices due to an absence of published literature addressing efficacy and safety.
2. Noncoverage of Extracorporeal Shockwave Therapy for Musculoskeletal Conditions
Extracorporeal Shockwave Therapy (ESWT) uses electrohydraulic or electromagnetic technology to generate acoustical shockwaves. ESWT devices are intended to direct the shockwaves at tissues to initiate:
• Structural changes on tissue,
• Stimulation of bone growth,
• Stimulation of the regenerative process in tissue, or
• Structural changes in calcium deposits followed by reabsorption of the calcium by the body.
ESWT is not a covered therapy for any indications including:
1) plantar fasciitis
2) lateral epicondylitis
3) shoulder tendonitis
4) delayed union of fractures or fracture nonunions
The Food and Drug Administration (FDA) has not approved ESWT for the treatment of shoulder tendinopathies or fractures. Furthermore, the published literature on ESWT does not substantially show the therapy's effectiveness for treating musculoskeletal conditions.
3. Noncoverage of the Otto Bock Vacuum Assisted Socket System
The Otto Bock Vacuum Assisted Socket System (VASS) includes a total surface bearing socket, Urethane interface/liner, sealing sleeves, and a vacuum pump/shock absorber. The technology is intended to:
• Maintain a balanced volume in an amputee's residual limb,
• Minimize limb movement in the socket,
• Facilitate perspiration evaporation within the socket,
• Reduce friction between the limb, liner, and socket.
VASS is not a covered device. The published literature on VASS does not substantially show the device's effectiveness for maintaining limb volume. This policy was issued August 1, 2003.
Contact Grace Wang, Mailstop 4321, phone (360) 902-5227.
Specialty Compliance Services Division
Minors and Bloodborne Pathogens in Nonmedical Settings
ES.C.4.2
To provide clarification regarding the child labor provision in WAC 296-125-030 which prohibits a minor from working in jobs where there is potential for exposure for bloodborne pathogens as defined in chapter 296-823 WAC. This policy is being amended to reflect the changes in the number for the WISHA Bloodborne standard from WAC 296-62-08001 and chapter 296-823 WAC. This policy was amended August 8, 2003.
Contact Carlena Anderson or Mary Miller, P.O. Box 44510, Olympia, WA 98504-4510, phone (360) 902-5315/(360) 902-6041.
School Week and Work Week for Minors ES.C.4.1
To clarify when the hours of work for minors apply for school and nonschool weeks, regardless of industry sector, and to clarify the exemptions to the hours of work rules. This policy was issued August 12, 2003.
Contact Carlena Anderson or Mary Miller, P.O. Box 44510, Olympia, WA 98504-4510, phone (360) 902-5315/(360) 902-6041.
Carmen Moore
Legislative and
Governmental Affairs Office