Injury Groups Used For Claim Estimates

One of the most important things that two NDS code categories are used for is the grouping of types of injuries to determine claim estimates.  In turn, these are used to help calculate premium costs for employers.

Each injury that is coded is broadly categorised into one of eleven areas as follows:

• Back

• All fractures, excluding back

• Sprains/strains, excluding back

• Open wounds

• Contusions/crushes

• External effects

• Multiple injuries

• Other injuries (including damage to aids/appliances)

• Occupational Overuse Syndrome

• Stress

• Other diseases

While a number of other factors also impact on the accuracy of a claim estimate, if the wrong codes are entered for Nature of Injury and Bodily Location, the estimate total can be significantly altered.

NDS codes for nature of injury and bodily location must be updated if a condition originally coded has now resulted in a more serious other injury.

This is because the more serious resultant injury will more accurately reflect the current claim circumstance and thus, its estimated cost and premium impact.

And while NDS codes may initially be devised and registered by a specialist coder (this will depend on how each state office undertakes NDS coding), it is ultimately the responsibility of the claims manager to ensure that the codes entered for the claim are correct.

These codes will be subject to Comcare quality control checks.