L&I Acupuncture Pilot Project

  • May 20, 2018 1:42 PM | Anonymous

    WEAMA membership meeting has been a great success and we thank everyone who came out!  Part of our mission for this meeting was to present a cheat sheet for all L&I providers to simplify the documentation requirements. In addition, please take advantage of the online documentation course WEAMA is sponsoring until the end of the pilot. Email us at info@weama.info for your free access code! 

    The following information is from our May Membership Meeting, enjoy! 

    Labor and Industry – acupuncture pilot in a nutshell

    Please inform yourself how to properly document a patient visit for L&I even if you do not currently have a patient with this insurance type. There is specific documentation required for a patient’s first visit.

    WEAMA sponsored the online course “How to document for workers’ comp” authored by Megan Kingsley Gale, LAc until Oct 1st, 2019. This sponsorship allows WEAMA’s membership to have free access to detailed documentation course – good for any insurance documentation. Email info@weama.info for a free access code during the pilot. WEAMA thanks Megan for her volunteer work for the board and on the L&I project.

    Most important FAQS to familiarize yourself with:

    • 1.     The pilot project was created to see how our profession follows documentation requirements – we have already proven acupuncture works.
    • 2.     Documentation is vital to the success of this pilot and the more professional the documentation the better our profession will be reimbursed in the future especially for E&M codes – provider vs technician. (Workers’ comp online course -> documentation.)
    • 3.     ONLY BILL ONE CODE ONCE PER VISIT-  Use this unique L&I code - 1582M. This code covers a minimum 30 min direct patient care – equivalent to two sets of needles and/or electro-acupuncture. “CPT codes 97810, 97811, 97813, and 97814 are not payable” -- Do not code those CPT codes.
    • 4.     DO NOT REQUEST MORE VISITS. Only 10 visits are approved by L&I – Each time a provider requests more visits L&I finds that our profession cannot follow requirements.
    • 5.     Maximum reimbursement is $107.78. You set your rates to what you want – L&I will not pay higher than $107.78 per patient visit.
    • 6.     Treatments only to be continued if there is documented, measured improvements shown midway through treatments.

    Documentation requirements:

                Mail claims: Department of Labor & Industries PO Box 44269

                                     Olympia, WA 98504-4269

                Fax Chart notes: 360-902-4567 – include claim # on top right of each page.

                Email test - Oswestry and Graded Chronic Pain Scale:                                  acupuncturepilot@lni.wa.gov

          1. Initial Visit: *Fax chart notes every time you mail a claim and email tests*

                a. Complete SOAP notes detailed well to code for E&M - Summary of              subjective complaints, objective findings and treatment plan focusing on          functional improvement.  – Use modifier 25 for E&M codes.

                b. Test – Include Oswestry Disability Index filled out by patient at initial visit.

                c. Test – Include Graded Chronic Pain Scale filled out by patient at initial visit.

                d. Test – Preform the Straight leg test etc – rule out any red flags

          2. Fifth Visit:

                a. Test – Include Oswestry Disability Index filled out by patient at fifth visit.

                b. Test – Include Graded Chronic Pain Scale filled out by patient at fifth visit.

          3. Final Visit:

                a. Required addition to chart note – Reason for Discharge of the patient          must be documented, from the following list: Goals met, Lack of            progress, Patient/ caregiver request (self-discharge), Medical              complication, Frequent no show/ cancellation                                                         (noncompliance), Insurance benefits expired, Care transfer (other facility/        level of care), or Other (please describe).

    How to find an attending provider to send introduction letters:

    • 1)    Go to www.findadoctor.lni.wa.gov and click on “Search for a doctor or provider.”
    • 2)    Select “All Providers” and enter address or zip code.

    Form Letter Draft Introducing Your Clinic to an LnI Attending Provider

    DRAFT Author: Megan Kingsley Gale

    [your clinic letterhead here…]

    Date: ____

    Dr.(s) _____ and office staff:

    Did you know that you can now have a new non-pharm pain relief referral option for your Workers’ Comp patients who have injuries related to low back pain on their open claim?

    In October 2016, Washington State L&I began the L&I Acupuncture Pilot Project.  Workers who have an open claim related to low back pain may be referred for up to 10 treatments with East Asian Medicine Practitioners (Acupuncturists) who have enrolled as approved providers in the Pilot.

    I/my clinic am/are one of those Pilot Providers and we are looking forward to receiving any of your patients who have not yet received acupuncture for their injury related to low back pain.

    You can contact us/reach us at ________[your clinic information here. Elaborate on your clinic here.]11

    Required documents can be found at the following URL:

    Oswestry: http://lni.wa.gov/ClaimsIns/Files/Providers/AcupuncturePilotODIformInstructions.pdf

    Graded Chronic Pain Scale: http://lni.wa.gov/ClaimsIns/Files/Providers/AcupuncturePilotGCPSformInterpretation.pdf

    DVRPS: http://www.asacu.org/wp-content/uploads/2018/03/Combined-One-Sheet.pdf

    L&I contacts:

    Acupuncture Pilot Information            Zachary Gray, Zachary.Gray@Lni.wa.gov

    Acupuncture Pilot Rulemaking Jami Lifka, Jami.Lifka@Lni.wa.gov

    Billing and Payment questions  Provider Hotline: 1-800-848-0811

  • November 28, 2017 9:06 AM | Shelley Dahle (Administrator)
    The Pilot has begun!  Are you prepared?  As a Pilot Participant, make sure you have access to the following resources to help you be as prepared and engaged in the Pilot as possible.  As a community, our overall engagement and preparation will affect the details of what the L&I  Rule will eventually state about acupuncture and East Asian Medicine Practitioners.

    1. Take the quick survey
    2. Join the Glip Discussion Group to have access to the Tuesday Training sessions and more
    3. Sign up/join the online course, Workers' Comp Documentation Toolkit. Coupons available for Pilot Providers and WEAMA members.  Contact Shelley at info@weama.info for details.
    4. Attend the in-person L&I Workshops, sponsored by WEAMA.  Our first one was after the Oct. 22nd, 2017, WEAMA meeting.  This structure of Q&A session with a state L&I Acupuncture Pilot Project representative plus a review of Physical Exam and Orthopedic Tests for Low Back Pain was a well-received model.

    Looking forward to hearing from you in the online course or at a training soon!

    Megan Kingsley Gale, MSAOM, EAMP, LMT
    WEAMA L&I Committee Lead

  • November 21, 2017 4:55 PM | Shelley Dahle (Administrator)
    Tuesday Trainings!
    We started "Tuesday Trainings", the online live training sessions at 11:00 a.m. for a series of  6 Tuesdays before the winter holiday break.  These live trainings are a supplement to the online course, the Workers' Comp Documentation Toolkit and include a live Q&A session after the presentation. Tuesday, 11.21.2017, was the 3rd "Tuesday Training".

    Tuesday Training sessions are free and open to all WA State L&I Acupuncture Pilot EAM Practitioners.  The sessions are held in the L&I Pilot Discussion Group, hosted by WEAMA.  To attend a session:  

    1. contact Shelley at WEAMA at ​info@weama.info to get your link to the Glip group.  
    2. Then, set up your Glip account and modify your notification settings (weekly or daily, etc, notifications of group activity).  
    3. On days of the online live trainings, sign in about 5 minutes early and click "join" when the button shows up in the group.  It can take a few minutes for a computer to join a live session for the first time.
    Looking forward to hearing from you in the online course or at a training soon!

    Megan Kingsley Gale, MSAOM, EAMP, LMT
    WEAMA L&I Committee Lead

  • October 29, 2017 12:46 PM | Anonymous member

    Dear L&I Acupuncture Pilot provider,
    WEAMA is inviting Acupuncture Pilot providers to a forum where you can help each other navigate the pilot.  This will also be the place for providers to receive documentation toolkit training from Megan Kingsley Gale.  Each pilot provider will be receiving an invitation from Glip.  Please follow the link to sign up for Glip from that email.

    Please note:  This group is for L&I Acupuncture Pilot providers to help each other navigate the pilot.  It will not be monitored by WEAMA or L&I.

    In order to be respectful of everyone on the team, please limit the hours for posts to 9 AM – 6 PM.  That way people who are using mobile devices (see below), won't be bothered by posts after hours.

    Here are some tutorials to familiarize yourself with Glip.  
    Glip introduction 1
    Glip introduction 2
    Collaborative notes
    Group file sharing
    Change email & desktop notification preferences 

    Chat/Video chat
    You can use Glip to chat or video chat with anyone in the team.  You can click on a name in the sidebar and chat or video chat with them.   Whenever you initiate or join a video chat, there will be a download from ring central, the company that owns Glip.  Allow the installation of that application.  When you first connect, you will have to choose your audio setting.  Choose computer audio.  

    Desktop & mobile apps
    We highly recommend that you use both of these.  The people who don't, miss out on the whole thing.  There are Mac and Windows versions.  Android and iOS versions.  You just log in one time and keep the apps running in the background.  The Desktop app has more features.  The phone app is useful to keep up with communications.  

    To download the apps, once you log in at Glip.com, look at the top left, click on > WEAMA 
    That opens up a dialog box.  In there, select > Glip Apps
    Download the apps there.

Workers Comp. Documentation Toolkit online course
Email info@weama.info for a free access code during the pilot. General information:  

Labor & Industries Acupuncture Pilot Project
How to find providers:  You can find EAMPs in the state who are participating in the Labor & Industries Acupuncture Pilot Project by using L&I's find a doctor tool.

Find a Doctor tool 
be sure to add your zip code, then under specialties choose acupuncture

How to properly document a

L_I brief for providers.pdf



L_I.DVPRS - ASA Combined-One-Sheet.pdf

For L&I Acupuncture Pilot Providers only
WEAMA is building a segmented list to share additional training for the pilot from WEAMA as well as a way to collaborate with your colleagues who are participating in the pilot.