Claims Management Tools for Invoices (Invoice Codes)

Billing invoices and claims detail sheets are issued to identify specific activities of the claims during a specific period of time. Billing codes are addressed to assist in reviewing all incoming bills for reimbursement to State Fund. Any changes or additions to any of the codes below will be posted in a prompt manner.

Compensation Payments
01	Permanent Partial Disability (PDR less than 100%)
02	Permanent Total Disability
1X	Temporary Partial Disability (Wage Loss)
06	Temporary Disability
15	Claimant Attorney Permanent Partial
16	Claimant Attorney Permanent Total
1B	Claimant Attorney Death Benefits
1C	Claimant Incurred Legal Expense
11	Claimant Attorney Temporary Disability
12	Claimant Attorney VR
13	Subsequent Injury - All Costs Except Doctors
14	Subsequent Injury - Doctors
1A	Death Benefits
17	Burial Expenses
18	State Salvage - Compensation Recovery
1T	Permanent Partial Disability Interest
DOIs Prior To 1-1-94
V1 (07)	VR1 Maintenance
V2 (08)	VR2 Testing and Evaluation
V3 (09)	VR3 Training

DOIs and Voc/Rehab Cases Commencing On Or After 1-1-94
1D	VR1 Inside Cap
1E	VR1 Outside Cap
1Q	VR3 Inside Cap
1R	VR3 Outside Cap
1H	Evaluation
1K	Plan Development
1F	Job Placement
1G	Job Placement Outside Cap
1J	Evaluation Outside Cap
1M	Plan Development Outside Cap
1N	Miscellaneous Inside Cap
1P	Miscellaneous Outside Cap
DOI’S Commencing On Or After 1-1-2004
0B	SJDB Voucher Expenses Reimbursed to Injured
0C	SJDB for Counseling Fees [To Counselor]
0D	SJDB Voucher Expenses Payable to Vendor

Medical Payments
20	Treating Physicians - all physicians, dentists, chiropractors, radiologists, Christian Science practitioners and acupuncturists
21	Hospitals - including nursing homes, convalescent homes, and sanitariums
22	MMC/External Vendor Fees
23	Payments to Injured - for transportation, living expense, medical reimbursement
24	Pharmacies
25	Medical Services - all ambulance, nurses, medical exams, x-rays, interpreters, blood banks, and gymnasiums
26	Appliances - all sellers, renters, manufacturers of artificial eyes, limbs, orthopedic appliances, beds, hearing aids, and glasses
27	All Reimbursement to Attorneys, Insurance Companies and Agencies - this is not reportable to IRS
28	Physical Therapy
29	Cost Containment - payments to cost containment vendors for bill review charges, etc.
30	Medical Evaluations and All Related Costs Procured by Applicant or Applicant's Attorney
31	Medical Evaluations and All Related Costs Procured by State Fund on Represented Claims
32	Medical Evaluations and All Related Costs Performed by AMEs/IMEs
33	Medical Evaluations and All Related Costs on Non-Represented Claims
34	Early Intervention - Used for State Cases Only

Loss Expense Payments (Pen/Arb - Penalty/Arbitration)
4A	Internal Bill Review Chargeback
71	Temporary Disability Late Payment Penalty Caused by Employer

Miscellaneous Services
Payment Code	Reimbursable Expense	Description
4F	IMR Fees	Independed Medical Review
4G	IBR Fees	Independed Bill Review
5A	Reports	Copy Work Request for hospital records Employment records or Military records Police or Highway Patrol records Dependency Records (birth, death, divorce, marriage certificates Social Security records Autopsy reports or Death Certificates
5B	Investigations	Outside Investigator Services Retail credit check Technical survey Outside defense attorney services
5C	Court Fees	Voluntary Arbitration Testimony of witness Interpreter fees Witness fees, including travel Subpoena services Transcript of testimony Depositions Notary fees Filing fees Mandatory arbitration
5D	Ergonomics/Safety	Ergonomic Assessments Safety Consultants, Environmental Quality Analysis Non- VR Job Analysis
5E	CEP	Claims Examiner Portal
5F	Managed Svcs	Managed Service fees for medical bills from outside vendor
Other
CC	Canceled Check
SP	Stop Payment
SV	Salvage (Subrogation Recovery)
RC	Returned Compensation Money
RM	Returned Medical Money

Claims Management Tools for Invoices (Invoice Codes)

Compensation Payments

DOIs Prior To 1-1-94

DOIs and Voc/Rehab Cases Commencing On Or After 1-1-94

DOI’S Commencing On Or After 1-1-2004

Medical Payments

Loss Expense Payments (Pen/Arb - Penalty/Arbitration)

Miscellaneous Services

Payment Code

Reimbursable Expense

Description

Other