Printing - FECA-PT2 - National Association of Letter Carriers

adjudication code D7, D8, or D9, as appropriate, and pay status UD.
(5) Noncontroverted no-time-lost cases which later require adjudication by the CE which
cannot be accepted immediately must be reopened. This may be done manually or by the
system, and the case status will be UN.
f. Death. Cases on which death benefits are to be paid must be placed
in status AF/DE, which allows payment of burial, administrative costs and
survivor benefits. AF/UD may be used for a case in which employment-related death is accepted
but documents such as birth certificates, marriage certificates, or election forms have not been
received. When there is no further entitled beneficiary
because of remarriage, completion of college, etc., the case should be closed
AF/C5.
2-0401-9 Inquiries
9. Inquiries. In addition to its essential use in enabling CEs to take timely and proper action on files,
and to enable supervisors to monitor case actions, the case management system provides basic
information to contact representatives and others for use in responding to inquiries. It is to the
advantage of the CE to maintain correct coding information in the system so that a representative can
answer telephone inquiries without having to contact the CE for information.
2-0401-10 ICD-9 Codes
10. ICD-9 Codes. When conditions are accepted as work-related, the CE should enter the
corresponding ICD-9 codes into the case management system. The codes are found in the ICD-9 manuals
or electronic ICD-9 reference material. As additional conditions are accepted, the ICD-9 codes should be
added to the system.
a. Severity of Condition. The ICD-9 code should accurately reflect the severity of the condition
accepted. For instance, if the OWCP has accepted a herniated
lumbar disc (code 722.10), the code for lumbar strain (847.2) should not be used instead. Coding
should be as specific as possible, coded to the 4 th or 5 th digit.
b. Surgery. When a surgical procedure has been accepted as work-related, the CE should
ensure that the accepted condition has been upgraded, when necessary, to ensure that bills will be
paid appropriately.
c. Psychiatric Conditions. When a claimant who has a physical work-related condition requires
treatment for a related psychiatric condition (e.g., depressive reaction), the CE must add the
psychiatric diagnosis to the system. Failure to do so may result in denial of bills for psychiatric
care.
d. Specific Identifiers. One-character identifiers unique to the case management system are
used to add more specificity to ICD-9 codes. These identifiers are:
R Right
L Left
FECA-PT2 Printed: 06/08/2010 34