Miscellaneous Payment Account Codes

00 – Debit to Risk / 05 – Debit to Surplus Handicap
01 – Debit to Surplus / 06 – Debit to Surplus Claim in Court
02 – Debit to Surplus Handicap / 07 – Debit to Surplus Non-locatable Risk
03 – Debit to Surplus Handicap Armed Service / 09 – Debit to DWRF
04 – Debit to Surplus Non-Compliance / 12 – Debit to Rehabilitation

Miscellaneous Payment Billing Codes

Type of Payment / Coding for that payment / How the check will read
Funeral Expenses / 90000 / Funeral Expenses
Death Benefits Widow / 96107 / Death Benefits
Death Benefits Children / 96108 / Death Benefits
Death Benefits Misc. / 96109 / Death Benefits
Court Cost - Direct / 94000 / Court Costs
Court Order pay med report and Police Reports / 99116 / Other
Rehab Payments / 99117 / Rehabilitation Services
Facial Disfigurement / 85105 / Facial Disfigurement
LSS Payment / 97000 / Lump Sum Settlement
LSA/AF / 98125 / Lump Sum Advancement
LSA/PTD / 98100 / Lump Sum Advancement
LSA/PP / 98105 / Lump Sum Advancement
PTD Payment / 96100 / Permanent Total
TT Payment / 96101 / Temporary Total
TP Payment / 96102 / Temporary Partial
PP Payment / 96105 / Permanent Partial
%PP Payment / 96106 / Percentage Permanent Partial
VSSR(Additional Award) / 96110 / Violation of Specific Safety Req
Change of Occupation / 96111 / Change of Occupation
LM Payment / 96113 / Living Maintenance
Mobility Grant / 96114 / Mobility Grant
Wage Agreement / 96115 / Employer Reimbursement
WL Payment / 96130 / Wage Loss
LMWL Payment / 96131 / Living Maintenance Wage Loss

Codes 94000,97000 and 99116 are the only codes you can pay on a medical only claim.

The checks will show only the type of payment and amount not the form and to date for the following codes: 85105, 90000, 94000, 97000, 98100, 98105, 98125, 99116, 99117 – and all other codes when you have a $0 weekly rate in miscellaneous payment.