BWC has specific requirements that are different from those common in the health-care industry as workers' comp only covers specific body parts
and conditions affected by the industrial injury or illness.
A claim is not a bill
In workers' comp we use claim to refer to everything related to an injury/illness report (FROI) and the injured worker's eligibility for benefits.
The claim has a specific number assigned to it that refers to the specific accident or disease that led to the industrial injury or illness.
We use bill or invoice to refer to the request for provider reimbursement (health-care claim). The bill must always contain the injured worker's
BWC claim number that refers to the related injury/illness. This distinction is very important as coding rules are very different for filing
claims and for medical billing.
- For claims (FROIs and additional allowances), we need specific diagnosis information, including site and location.
- For medical bills, we ask providers to follow national billing standards, which allow for less specific coding.
The following pages describe the coding differences in more detail and provide BWC-specific documents to assist you in understanding workers'
ICDs for claim conditions
ICDs for billing
Seventh Character Description for ICD-10