| 296-20-010 | General information. |
| 296-20-0100 | Industrial insurance chiropractic advisory committee. |
| 296-20-01001 | Industrial insurance medical advisory committee. |
| 296-20-01002 | Definitions. |
| 296-20-01010 | Scope of health care provider network. |
| 296-20-01020 | Health care provider network enrollment. |
| 296-20-01030 | Minimum health care provider network standards. |
| 296-20-01040 | Health care provider network continuing requirements. |
| 296-20-01050 | Health care provider network further review and denial. |
| 296-20-01060 | Delegation of credentialing and recredentialing activities. |
| 296-20-01070 | Waiting periods for reapplying to the network. |
| 296-20-01080 | Management of the provider network. |
| 296-20-01090 | Request for reconsideration of department decision. |
| 296-20-01100 | Risk of harm. |
| 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 | Initiating treatment and submitting a claim for benefits. |
| MEDICAL COVERAGE DECISIONS |
| 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? |
| TREATMENT AUTHORIZATION REQUIREMENTS |
| 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. |
| MEDICATION RULES |
| 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? |
| OPIOIDS FOR NONCANCER PAIN |
| 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. |
| 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 providers. |
| 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. |
STRUCTURED INTENSIVE MULTIDISCIPLINARY
PROGRAM (SIMP) FOR CHRONIC NONCANCER PAIN |
| 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 | Application process for providers outside the scope of the provider network. |
| BILLING |
| 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. |
| IMPAIRMENT RATING |
| 296-20-19000 | What is a permanent partial disability award? |
| 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. |
| 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. |