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Workers Compensation EDI Code Lists
Kansas Electronic Data Interchange (EDI)
Release 1 Code Lists
Source: IAIABC EDI Implementation Guide
for First, Subsequent, Acknowledgement Detail,
Header, & Trailer Records
Release 1 February 15, 2002
TABLE 1: FIPS Codes
(DN04 Jurisdiction)
FIPS (Federal Information Processing Standards) Alpha
State Codes for the States and the District of Columbia
| FIPS State Name |
Code |
FIPS State Name |
Code |
| Alabama |
AL |
Missouri |
MO |
| Alaska |
AK |
Montana |
MT |
| Arizona |
AZ |
Nebraska |
NE |
| Arkansas |
AR |
Nevada |
NV |
| California |
CA |
New Hampshire |
NH |
| Colorado |
CO |
New Jersey |
NJ |
| Connecticut |
CT |
New Mexico |
NM |
| Delaware |
DE |
New York |
NY |
| District of Columbia |
DC |
North Carolina |
NC |
| Florida |
FL |
North Dakota |
ND |
| Georgia |
GA |
Ohio |
OH |
| Hawaii |
HI |
Oklahoma |
OK |
| Idaho |
ID |
Oregon |
OR |
| Illinois |
IL |
Pennsylvania |
PA |
| Indiana |
IN |
Rhode Island |
RI |
| Iowa |
IA |
South Carolina |
SC |
| Kansas |
KS |
South Dakota |
SD |
| Kentucky |
KY |
Tennessee |
TN |
| Louisiana |
LA |
Texas |
TX |
| Maine |
ME |
Utah |
UT |
| Maryland |
MD |
Vermont |
VT |
| Massachusetts |
MA |
Virginia |
VA |
| Michigan |
MI |
Washington |
WA |
| Minnesota |
MN |
West Virginia |
WV |
| Mississippi |
MS |
Wisconsin |
WI |
| Wyoming |
WY |
|
|
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TABLE 7: Part of Body Codes
(DN36 Part of Body Injured Code)
I. HEAD
| 10 |
Multiple Head Injury - any combination
of below parts |
| 11 |
Skull |
| 12 |
Brain |
| 13 |
Ear(s) - includes: hearing, inside
eardrum |
| 14 |
Eye(s) - includes: optic nerves,
vision, eyelids |
| 15 |
Nose - includes: nasal passage,
sinus, sense of smell |
| 16 |
Teeth |
| 17 |
Mouth - includes: lips, tongue,
throat, taste |
| 18 |
Soft Tissue |
| 19 |
Facial Bones - includes jaw |
II. NECK
20
|
Multiple Neck Injury - any combination
of below parts, excluding hands and wrists combined |
| 21 |
Vertebrae - includes: spinal column
bone, "cervical segment" |
| 22 |
Disc - includes spinal column cartilage,
"cervical segment" |
| 23 |
Spinal Cord - includes: nerve tissue,
"cervical segment" |
| 24 |
Larynx - includes: cartilage and
vocal cords |
| 25 |
Soft Tissue - other than larynx
or trachea |
| 26 |
Trachea |
III. UPPER EXTREMITIES
30
|
Multiple Upper Extremities - any
combination of below parts, excluding hands and wrists combined |
31
|
Upper Arm - Humerus and corresponding
muscles, excluding clavicle and scapula |
| 32 |
Elbow - radial head |
| 33 |
Lower Arm - forearm - radius, ulna,
and corresponding muscles |
| 34 |
Wrist - carpals and corresponding
muscles |
35
|
Hand - metacarpals and corresponding
muscles (excluding wrist or fingers) |
| 36 |
Finger(s) - other than thumb and
corresponding muscles |
| 37 |
Thumb |
| 38 |
Shoulder(s) - armpit, rotator cuff,
trapezius, clavicle, scapula |
| 39 |
Wrist(s) and Hands(s) |
Back to Top
IV. TRUNK
| 40 |
Multiple Trunk - any combination
of below parts |
41
|
Upper Back Area (Thoracic Area)
- upper back muscles, excluding vertebrae, disc, spinal cord |
42
|
Low Back Area (Lumbar Area and Lumbo-Sacral)
- lower back muscles, excluding sacrum, coccyx, pelvis, vertebrae,
disc, spinal cord |
| 43 |
Disc - spinal column cartilage other
than cervical segment |
| 44 |
Chest - including Ribs, Sternum
and soft tissue |
| 45 |
Sacrum and Coccyx - final nine vertebrae
- fused |
| 46 |
Pelvis |
| 47 |
Spinal Cord - nerve tissue other
than cervical segment |
| 48 |
Internal Organs - other than heart
and lungs |
| 49 |
Heart |
| 60 |
Lungs |
| 61 |
Abdomen Including Groin - excluding
injury to internal organs |
| 62 |
Buttocks - soft tissue |
63
|
Lumbar and/or Sacral Vertebrae (Vertebrae
NOC Trunk) - bone portion of the spinal column |
V. LOWER EXTREMITIES
| 50 |
Multiple Lower Extremities - any
combination of below parts |
| 51 |
Hip |
| 52 |
Upper Leg - femur and corresponding
muscles |
| 53 |
Knee - patella |
| 54 |
Lower Leg - tibia, fibula, and corresponding
muscles |
| 55 |
Ankle - tarsals |
56
|
Foot - metatarsals, heel, Achilles
tendon and corresponding muscles (excluding ankle or toes) |
| 57 |
Toe(s) |
| 58 |
Great Toe |
VI. MULTIPLE BODY PARTS
| 64 |
Artificial Appliance - braces, etc. |
65
|
Insufficient Info to Properly Identify
- Unclassified - insufficient information to identify part affected |
| 66 |
No Physical Injury - mental disorder |
90
|
Multiple Body Parts (including body
systems and body parts) - applies when more than one major body
part has been affected such as an arm and a leg and multiple
internal organs |
91
|
Body Systems and Multiple Body Systems
- applies to the functioning of an entire body system that has
been affected without spedific injury to any other part, as
in the case of poisoning, corrosive action, inflammation affecting
internal organs, damage to nerve centers, etc. Does NOT apply
when the systemic damage results from an external injury affecting
an external part, such as a back injury which includes damage
to the nerves of the spinal cord. |
Source:
ASWG (Advisory Statistical Work Group); code list dated 1/16/98
Available from:
National Council on Compensation Insurance
Products and Services
901 Peninsula Corporate Circle
Boca Raton FL 33487
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TABLE 8: Nature of Injury Codes
(DN35 Nature of Injury Code)
I. SPECIFIC INJURY
01
|
No Physical Injury - i.e. glasses,
contact lenses, artificial appliance, replacement of artificial
appliance |
02
|
Amputation - cut off extremity,
digit, protruding part of body, usually by surgery, i.e. leg,
arm |
| 03 |
Angina Pectoris - chest pain |
04
|
Burn - (heat) burns or scald: the
effect of contact with hot substances (chemical) burns: tissue
damage resulting from the corrosive action of chemicals, fumes,
etc. (acids, alkalis) |
| 07 |
Concussion - brain, cerebral |
| 10 |
Contusion - bruise - intact skin
surface; hematoma |
| 13 |
Crushing - to grind, pound, or break
into small bits |
16
|
Dislocation - pinched nerve, slipped/ruptured
disc, herniated disc, sciatica, complete tear, H.P.subluxation,
MD dislocation |
| 19 |
Electric Shock - electrocution |
| 22 |
Enucleation - removal of organ or
tumor |
| 25 |
Foreign Body |
| 28 |
Fracture - breaking of bone or cartilage |
30
|
Freezing - frostbite and other effects
of exposure to low temperature |
31
|
Hearing Loss or Impairment - traumatic
only: a separate injury, not the sequella of another injury |
32
|
Heat Prostration - heat stroke,
sun stroke, heat exhaustion, heat cramps and other effects of
environmental heat; does not include sunburn |
34
|
Hernia - the abnormal protrusion
of an organ or part through the containing wall of its cavity |
36
|
Infection - the invasion of a host
by organisms such as baceria, fungi, viruses, protozoa or insects,
with or without manifest disease |
37
|
Inflammation - the reaction of tissue
to injury characterized clinically by heat, swelling, redness,
and pain |
40
|
Laceration - cuts, scratches, abrasions,
superficial wounds, calluses, wound by tearing |
41
|
Myocardial Infarction - heart attack,
heart conditions, hypertension; the inadequate blood flow to
the muscular tissue of the heart |
42
|
Poisoning - General (Not OD or Cumulative
Injury) - a systemic morbid condition resulting from the inhalation,
ingestion or skin absorption of a toxic substance affecting
the metabolic system, the nervous system, the circulatory system,
the digestive system, the respiratory system, the excretory
system, the musculoskeletal system, etc.; includes chemical
or drug poisoning, metal poisoning, organic diseases and venomous
reptile and insect bites; does NOT include effects of radiation,
pneumoconiosis, corrosive effects of chemicals, skin surface
irritations, septicemia, or infected wounds |
| 43 |
Puncture - a hole made by the piercing
or a pointed instrument |
| 46 |
Rupture |
| 47 |
Severance - to separate, divide,
or take off |
49
|
Sprain - internal derangement;
a trauma or wrenching of a joint, producing pain and disability
depending on degree of injury to ligaments |
52
|
Strain - internal derangement; the
trauma to the muscle or musculotendinous unit from violent contraction
or excessive forcible stretch |
| 53 |
Syncope - swooning, fainting, passing
out; no other injury |
| 54 |
Asphyxiation - strangulation, drowning |
55
|
Vascular - cerebrovascular and other
conditions of circulatory systems NOC, excludes heart and hemorrhoids;
includes strokes, varicose veins - non-toxic |
| 58 |
Vision Loss |
| 59 |
All Other Specific Injuries, NOC |
Back to Top
II. OCCUPATIONAL DISEASE OR CUMULATIVE INJURY
| 60 |
Dust Disease NOC (All other Pneumoconiosis) |
61
|
Asbestosis - lung disease; a form
of pneumoconiosis, resulting from protracted inhalation of asbestos
particles |
62
|
Black Lung - the chronic lung disease
or pneumoconiosis found in coal miners |
| 63 |
Byssinosis - the pneumoconiosis
of cotton, flax, and hemp workers |
64
|
Silicosis - pneumoconiosis resulting
from inhalation of silica (quartz) dust |
| 65 |
Respiratory Disorders (Gases, Fumes,
Chemicals, etc.) |
| 66 |
Poisoning - Chemical (Other than
Metals) |
| 67 |
Poisoning - Metal - man-made |
68
|
Dermatitis - rash, skin, or tissue
inflammation including boils, etc.: generally resulting from
direct contact with irritants or sensitizing chemicals such
as drugs, oils, biologic agents, plants, woods, or metals which
may be in the form of solids, pastes, liquids or vapors and
which may be contacted in the pure state or in compounds or
in combination with other materials; do NOT include skin tissue
damage resulting from corrosive action of chemicals, burns from
contact with hot substances, effects of exposure to radiation,
effects of exposure to low temperatures or inflammation or irritation
resulting from friction or impact |
69
|
Mental Disorder - a clinically significant
behavioral or psychological syndrome or pattern typically associated
with either a distressing symptom or impairment of function,
i.e. acute anxiety, neurosis, stress, non-toxic depression |
70
|
Radiation - all forms of damage
to tissue, bones or body fluids produced by exposure to radiation |
71
|
All Other Occupational Disease Injury
NOC |
| 72 |
Loss of Hearing |
| 73 |
Contagious Disease |
| 74 |
Cancer |
| 75 |
AIDS |
76
|
VDT-Related Disease - video display
terminal disease other than carpal tunnel syndrome |
| 77 |
Mental Stress |
78
|
Carpal Tunnel Syndrome - soreness,
tenderness and weakness of the muscles of the thumb caused by
pressure on the median nerve at the point where it goes through
the carpal tunnel of the wrist. May involve damage to the hands,
wrists, forearms, elbow and shoulders. May also include ganglion
cysts in the wrist area. |
| 80 |
All Other Cumulative Injuries, NOC |
III. MULTIPLE INJURIES
| 90 |
Multiple Physical Injuries Only |
| 91 |
Multiple Injuries Including Both
Physical and Psychological |
Source: ASWG (Advisory
Statistical Work Group); code list dated 1/16/98
Available from:
National Council on Compensation Insurance
Products and Services
901 Peninsula Corporate Circle
Boca Raton FL 33487
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TABLE 9: Cause of Injury Codes
(DN37 Cause of Injury Code)
I. BURN OR SCALD-HEAT
OR COLD EXPOSURE
| 01 |
Chemicals |
| 02 |
Hot Object or Substances |
| 03 |
Temperature Extremes |
| 04 |
Fire or Flame |
| 05 |
Steam or Hot Fluids |
| 06 |
Dust, Gases, Fumes or Vapors |
| 07 |
Welding Operations |
| 08 |
Radiation |
| 09 |
Contact With, NOC |
| 11 |
Cold Objects or Substances |
| 14 |
Abnormal Air Pressure |
| 84 |
Electrical Current |
II. CAUGHT IN, UNDER, OR BETWEEN
| 10 |
Machine or Machinery |
| 12 |
Object Handled |
| 13 |
Caught In, Under, or Between, NOC |
| 20 |
Collapsing Materials (Slides of
Earth) - either man made or natural |
III. CUT, PUNCTURE, SCRAPE, INJURED BY
| 15 |
Broken Glass |
| 16 |
Hand Tool, Utensil; Not Powered |
| 17 |
Object Being Lifted or Handled |
| 18 |
Powered Hand Tool, Appliance |
| 19 |
Cut, Puncture, Scrape, NOC |
IV. FALL, SLIP OR TRIP INJURY
| 25 |
From Different Level (Elevation)
- off wall, catwalk, bridge, etc. |
| 26 |
From Ladder or Scaffolding |
| 27 |
From Liquid or Grease Spills |
| 28 |
Into Openings - shafts, excavations,
floor openings, etc. |
| 29 |
On Same Level |
| 30 |
Slipped, Did Not Fall |
| 31 |
Fall, Slip, Trip, NOC |
| 32 |
On Ice or Snow |
| 33 |
On Stairs |
Back to Top
V. MOTOR VEHICLE
| 40 |
Crash of Water Vehicle |
| 41 |
Crash of Rail Vehicle |
45
|
Collision or Sideswipe with Another
Vehicle - both vehicles in motion |
46
|
Collision with a Fixed Object -
standing vehicle or stationary object |
| 47 |
Crash of Airplane |
| 48 |
Vehicle Upset - overturned or jackknifed |
| 50 |
Motor Vehicle, NOC |
VI. STRAIN OR INJURY BY
| 52 |
Continual Noise |
| 53 |
Twisting |
| 54 |
Jumping |
| 55 |
Holding or Carrying |
| 56 |
Lifting |
| 57 |
Pushing or Pulling |
| 58 |
Reaching |
| 59 |
Using Tool or Machinery |
| 60 |
Strain or Injury By,
NOC |
| 61 |
Wielding or Throwing |
| 97 |
Repetitive Motion - carpal tunnel
syndrome |
VII. STRIKING AGAINST OR STEPPING ON
| 65 |
Moving Parts of Machine |
| 66 |
Object Being Lifted or Handled |
| 67 |
Sanding, Scraping, Cleaning Operation |
| 68 |
Stationary Object |
| 69 |
Stepping on Sharp Object |
| 70 |
Striking Against or Stepping On,
NOC |
VIII. STRUCK OR INJURED BY - INCLUDES KICKED, STABBED, BIT, ETC.
| 74 |
Fellow Worker, Patient |
| 75 |
Falling or Flying Object |
| 76 |
Hand Tool or Machine in Use |
| 77 |
Motor Vehicle |
| 78 |
Moving Parts of Machine |
| 79 |
Object Being Lifted or Handled |
| 80 |
Object Handled by Others |
| 81 |
Struck or Injured, NOC - includes
kicked, stabbed, bit, etc. |
| 85 |
Animal or Insect |
| 86 |
Explosion or Flare Back |
Back to Top
IX. RUBBED OR ABRADED BY
| 94 |
Repetitive Motion - callous, blister,
etc. |
| 95 |
Rubbed or Abraded, NOC |
X. MISCELLANEOUS CAUSES
| 82 |
Absorption, Ingestion or Inhalation,
NOC |
| 87 |
Foreign Matter (Body) in Eye(s) |
| 88 |
Natural Disasters |
| 89 |
Person in Act of a Crime - robbery
or criminal assault |
| 90 |
Other Than Physical Cause of Injury |
| 91 |
Mold |
| 96 |
Terrorism |
| 98 |
Cumulative, NOC - all other |
| 99 |
Other - Miscellaneous, NOC |
Source:
ASWG (Advisory Statistical Work Group); code list dated 1/16/98
Available from:
National Council on Compensation Insurance
Products and Services
901 Peninsula Corporate Circle
Boca Raton FL 33487
For assistance, contact us at:
Kansas Department of Labor
Workers Compensation
800 SW Jackson, Suite 600
Topeka, KS 66612-1227
(785) 296-4120.
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