EDI Standard Forms, Codes, and Resources

Trading Partner Documents
Trading partner documents, used to establish the method and frequency of sending and receiving electronic reports, including instructions, can be downloaded for completion prior to implementation.

IAIABC Electronic Partnering Agreement (08/26/2003)

IAIABC Electronic Partnering Agreement Instructions (05/20/2004)

IAIABC Electronic Partnering Claims Administrator ID List (07/20/2006)

IAIABC Electronic Partnering CA Address List (04/06/2008)

IAIABC Electronic Trading Partner Profile (07/01/2005)

IAIABC Electronic Transmission Profile (04/09/2008)

Standard Code Structures
The following are links to websites which contain the code lists for each data element listed below. Refer to the jurisdiction implementation manuals and Trading Partner Agreements to determine which of these version of the codes should be used and which are accepted in that jurisdiction.

Country Code (use 2 digit 3166-1 codes)

State Code:
United States
Canada
Mexico

Industry Code

Nature of Injury Code

Cause of Injury Code

Part of Body Injured Code

Permanent Impairment Body Code Part

Employee Leasing Policy Identification, WCPOLS Codes, etc. (as noted in POC)

Managed Care Organization (MCO) Code (DN0207, used in Claims Release 3)  Please see page 12 of section 4 for the listing of codes for Field #93. 

Additional Resources

Error Message Dictionary (02/22/2007)
The Error Message Dictionary is intended to assist in the use and selection of error messages adopted by the product’s Trading Partner Edit Matrix Table.

Glossary (10/30/2008)
The Glossary provides definitions of acronyms and terms used in the adopted IAIABC Implementation Guides.  These terms are not intended to define or describe Data Elements that are included in the standards.  Definitions of adopted Data Elements will be found in the product’s dictionary.

Interchange Version ID & Acknowledgment Mapping (04/06/2006)
The EDI Interchange Version ID and acknowledgment mapping is a table that illustrates the Interchange Version ID for each IAIABC EDI product, the products implementation date, and the acknowledgment relationship to the product’s EDI transactions.

Model Rule for Electronic Medical Billing for Workers' Compensation - Draft (09/02/2009)
The purpose of this Rule is to provide a legal framework for electronic billing, processing, and payment for medical services and products provided to injured employees. 

Forms

IA-1 FROI 2002 (OSHA Compliant)

IA-2 Subsequent Report of Injury Form (01/01/1999)

POC Form (From May 2002 POC Implementation Guide, pages 8.5-8.12)