Claims Management Tools for Invoices (Invoice Codes)

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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)

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
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