A unique number allocated For a new claim Claims C084 MEDICAL Optional CERTIFICATE by Medicare to identify this feld is PROVIDER NUMBER the provider supplying the mandatory, for an medical certificate. update to a claim if any of the fields C131, C083, C084 are populated to indicate a new medical certificate, then all three fields are mandatory and C084 is optional The capacity to work as For a new claim Claims C085 CAPACITY TO WORK Conditional 01 Fit for AT MEDICAL injury duties, shown on the Workers’ this feld is CERTIFICATE including fit but Compensation medical mandatory, for an requiring further certificate received for the update to a claim if treatment. worker (whether it is a any of the fields 02 Fit for First, Progress or Final C131, C083, C084 restricted return to certificate) or other are populated to work or for indication of the worker’s indicate a new alternative duties. fitness for work (e.g., medical certificate, 03 for work. report). then all three fields are mandatory and C084 is optional
Claims C084 MEDICAL CERTIFICATE PROVIDER NUMBER A unique number allocated by Medicare to identify the provider supplying the medical certificate. Optional For a new claim this feld is mandatory, for an update to a claim if any of the fields C131, C083, C084 are populated to indicate a new medical certificate, then all three fields are mandatory and C084 is optional Claims C085 CAPACITY TO WORK AT MEDICAL CERTIFICATE The capacity to work as shown on the Workers’ Compensation medical certificate received for the worker (whether it is a First, Progress or Final certificate) or other indication of the worker’s fitness for work (e.g., report). Conditional 01 Fit for duties, including fit but requiring further treatment. 02 Fit for restricted return to work or for alternative duties. 03 for work. For a new claim this feld is mandatory, for an update to a claim if any of the fields C131, C083, C084 are populated to indicate a new medical certificate, then all three fields are mandatory and C084 is optional injury
NIDS_V_8.0.docx