Disease codes: deciphering diagnoses on sick leave

Author: Maria Novikova

To make filling out a sick leave certificate extremely simple and optimize the process of further registration of the form, doctors use medical diagnosis

according to ICD. An ordinary person who has not previously encountered coding does not understand what is written on the certificate of incapacity for work. It is irrational to remember all the codes in such situations. To quickly understand the issue, do not bother your head with unnecessary knowledge. To do this, it is enough to know where to look for the necessary information.

diagnosis codes will help you navigate through “classified” information

medical diseases according to
ICD 10
with decoding, which have not changed in 2022, and correspond to the international classification. This material contains reliable and current information about the meaning of the data contained in sick leave certificates, as well as the rules governing the entry of information into documents.

What it is?

In accordance with the requirements of Federal Law No. 255 of December 29, 2006

, payment for the period of temporary disability is provided on the basis of sick leave.
The requirements for filling out the document are enshrined in Order of the Ministry of Social Development of the Russian Federation No. 624n dated June 29, 2011
, the form of the document was approved
by Order of the Ministry of Social Development of the Russian Federation No. 347 dated April 26, 2011
. The form must contain mandatory information, which includes:

• dates of submission of documents;
• the name of the institution where the certificate is issued and the address of the organization;
• information about the citizen receiving a certificate of temporary incapacity for work;
• information about the company in which the person works;
• information about the doctor who filled out the document;
• the moment of commencement of labor activity.

The doctor provides the completed documents. In addition to basic information, the sick leave certificate must contain a disease code

.
It is indicated in the “reason” line. The table of disease diagnosis codes on sick leave in Russia and their decoding are enshrined in the order of the Ministry of Social Development of the Russian Federation No. 347 dated April 26, 2011
.

The code is a digital designation of the cause of temporary disability. Entering information using this method allows you to achieve the following goals:

• save space in the document;
• simplify the functioning of the organization’s HR department;
• simplify interaction between different medical institutions.

When medical codes for disease diagnoses are used, even a doctor at a foreign clinic can understand the information specified in the document.

Modern classification

If a person is interested in a classifier of disease codes, it is worth turning to the order of the Ministry of Social Development of the Russian Federation No. 347n dated April 26, 2011

. The sets of numbers contained in the legal act can be divided into several categories:

1. Causes
   of temporary disability.
   The Order of the Ministry of Social Development provides for 15 of them. The codes included in this category are a two-digit combination
   of numbers, which is presented in the cell of the same name located opposite the line of the reason for disability. It is allowed to make adjustments to the certificate of incapacity for work. If the data needs to be changed, a new set of numbers is entered in the “change code” cell. It is located next to the original column.
2. Additional
   data. In some situations, their presentation may be required next to the main set of numbers. Information must be written if a person falls ill as a result of intoxication, is being treated in a sanatorium, takes additional maternity leave, or is being treated in an organization that is classified as a research institution.
3. Reflecting a family connection
   . Numerical designations included in this category are written above the line of the same name if a person is unable to continue working due to the need to care for a sick family member.
4. Violation of
   treatment regimen. Data is entered opposite the line of the same name if such an incident took place.
5. Other codes
   .
   The combination of numbers included in this category is recorded opposite the “Other” line. With its help, a doctor can record significant information about health status
   .
6. Reflecting the features of calculating
   sick leave benefits. The information is entered in the “accrual conditions” column.

Separately from the rest, there is a subordination

. It is not unified. A set of numbers is entered into the document depending on the region in which the company is registered. To find out the code, you will need to contact your local FSS departments.

Code names

In total, there are 5 types of encoded information on the sick leave. The fields for codes are marked in red in the illustration of the document form.

The medical institution enters the following encrypted information:

• Reason for disability - this field must be filled in.
• Family connection - this column is filled in if the employee takes out a certificate of incapacity for work (LS) to care for a sick relative.
• Notes on violation of the regime - codes in this category can significantly reduce sick leave payments.
• Other - the encoding in this field reflects the reasons for continuing or closing the LN.

The employer codes the column “Calculation conditions” on the sick leave sheet. It contains information about benefits or reasons for reducing payments to a sick employee. Based on encrypted data, accounting calculates the amount of compensation due. Control over the payment of the certificate of incapacity for work is carried out by the Social Insurance Fund (FSS) - it may not pay for the certificate if there are errors in it.

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What does disability reason code 01 mean on a sick leave certificate - explanation

, code 01 is affixed to temporary disability documents.

. It confirms the fact that a person cannot perform his professional duties for a certain period due to illness. Decoding the disease code 01 on the sick leave only partially reveals the necessary information.

This code hides classic diseases that usually do not threaten

citizen health.
If the document contains the designation 01, the employer will accrue payments as usual, guided by the provisions of paragraph 1 of Article 14 of Federal Law No. 255 of December 29, 2006
.

Auto-filling of the “Sick Leave” based on information about the certificate of incapacity for work

ZUP 3.1 implements auto-filling of the details of the Sick Leave (Personnel - Sick Leave) according to the information entered in the form Certificate of Incapacity for Work . This applies to paper sick leave. Previously, information about such certificates of incapacity for work had to be entered twice: on the Main the document Sick leave and in the form Certificate of incapacity for work . Now there is no need to duplicate information.

In order for the Sick Leave to be filled in with information about the certificate of incapacity for work, you must first enter the data in the Form Certificate of Incapacity for Work , and then click Fill out the sick leave .

As a result, the main details of the Main will be filled in automatically.

If the document contains code 04

If the injury occurred at work

, the document will contain code 04. In this situation, the features of providing the payment change.
Its size is regulated by Article 9 of Federal Law No. 125 of July 24, 1998
. The legal act states:

“Temporary disability benefits due to an industrial accident or occupational disease are paid for the entire period of temporary disability of the insured until his recovery or permanent loss of professional ability is established in the amount of 100 percent

his average earnings, calculated in accordance with
Federal Law of December 29, 2006 N 255-FZ “On compulsory social insurance in case of temporary disability and in connection with maternity
.”

This means that the company is obliged to provide the citizen with a payment in the amount of 100%

from his average earnings.

Cases of caring for sick children

The case of child care can now be clarified on the Main . You need to open the menu using the button with three dots located next to Cause of disability , select the child’s age and treatment regimen. Previously, a child care case was selected from the list on the Child Care .

Was:

Became:

What does disability reason code 11 mean - explanation

If code 11 is present on the temporary disability certificate, this indicates that the person suffered from a disease included in the list of socially significant diseases - tuberculosis

.
Treatment in this case is significantly prolonged. Its period is regulated by the provisions of Order No. 323 of November 21, 2011
.
of the regulatory legal act
states:

“If there is an obvious unfavorable clinical and work prognosis, no later than four months from the date of the onset of temporary disability, the patient is sent to undergo a medical and social examination in order to assess disability, and in case of refusal to undergo a medical and social examination, the certificate of incapacity for work is closed. With a favorable clinical and work prognosis, no later than ten months from the date of the onset of temporary disability in conditions after injuries and reconstructive operations and no later than twelve months in the treatment of tuberculosis, the patient is either discharged to return to work or sent for a medical and social examination.”

The employer must be prepared to compensate for the entire period the employee undergoes treatment. In a number of situations, a citizen can provide a medical order for transfer to another position

according to your health condition.
The company will be obliged to provide the citizen with a new place of work or remove the person from performing professional duties. In this situation, the employee must be provided with temporary disability benefits. This rule is enshrined in Article 73 of the Labor Code of the Russian Federation and Federal Law No. 77 of June 18, 2001
.

Violations of the regime

It is not enough to know what code 2 means on a sick leave certificate. This code can be supplemented with other digital designations that allow the employer to reduce the amount of payment. In accordance with the provisions of Order of the Ministry of Social Development of the Russian Federation No. 347n dated April 26, 2011

, in the “regime violation mark” line, the following codes may be present:

• 23
  - failure to comply with the prescribed regimen, unauthorized leaving the hospital, traveling for treatment to another administrative region without the permission of the attending physician;
• 24
  — late attendance at a doctor’s appointment;
• 25
  - going to work without being discharged;
• 26
  - refusal to refer to a medical and social examination institution;
• 27
  — untimely attendance at the medical and social examination institution;
• 28
  - other violations.

Types of codes

The mode of incapacity for work established by the attending physician is reflected on the sheet with the main and additional codes.

The sick leave certificate can also reflect the patient’s violation of the incapacity regime, the specifics of its completion, the issuance of a new sick leave certificate, the occurrence of events leading to complete or partial loss of ability to work, as well as family ties if caring for a sick family member.

Basic disability codes

Basic codes reflect the cause of disability. These include:

• 01 – a disease that prevents the employee from performing his duties or may lead to infection of other persons when he appears at the workplace;
• 02 – getting injured;
• 03 – establishment of a quarantine limiting the movement of the employee and his ability to visit the workplace;
• 04 – inability to work due to an accident related to production activities or subsequent illness;
• 05 – appointment of maternity leave;
• 06 – the need for prosthetics in stationary conditions;
• 07 – detection or exacerbation of a disease caused by professional conditions;
• 08 – sending an employee for further treatment to a sanatorium-resort institution;
• 09 – the need to care for a sick family member;
• 10 – other health disorders that caused the patient’s disability.

For individual cases associated with different causes of disability, codes may also be indicated:

• 11 – if the disease is socially significant;
• 12 – if care is needed for a child under 7 years of age due to an illness that allows the payment of child care benefits for 90 days a year;
• 13 – if caring for a disabled minor is necessary;
• 14 – if the child’s illness is associated with a post-vaccination complication or malignant neoplasm;
• 15 – if caring for a child with HIV infection.

Additional disability codes

Additional codes determine the features of the work release mode:

• 017 – stay in a sanatorium specializing in specific diseases;
• 018 – undergoing sanatorium-resort treatment related to an industrial accident, before sending the patient for a medical and social examination;
• 019 – treatment at a medical research institute;
• 020 – registration of additional maternity leave;
• 021 – treatment for illness or injury resulting from intoxication or associated with the influence of alcohol, drugs or toxic substances.

Disability violation codes

Violations of the incapacity regime mean:

• 23 – violation of the requirements and recommendations of the attending physician, unauthorized termination of treatment in a hospital setting or referral to another doctor for the same disease without the permission of the attending physician;
• 24 – missing an appointment with a doctor, subject to agreement on the date and time of the next examination;
• 25 – unauthorized going to work without closing the certificate of incapacity for work;
• 26 – refusal of medical and social examination;
• 27 – failure to appear for a medical and social examination;
• 28 – other violations.

Violation of the regime is reflected on the sick leave certificate, regardless of the presence or absence of valid reasons.

Codes associated with individual features of closing sick leave

If necessary, when closing sick leave, the doctor reflects the need to extend the period of incapacity, changes in health status that have occurred that prevent the continuation of work or require adjustment of the patient’s working conditions, and other features.

They are reflected by the following codes:

• 31 – the patient was issued a continuation of sick leave;
• 32 – the patient has been diagnosed with a disability;
• 33 – the patient’s disability group has been changed;
• 34 – the patient died;
• 35 – the patient refused to undergo a medical and social examination;
• 36 – the patient missed the scheduled time for the next examination, and at the next visit was declared able to work;
• 37 – the patient is sent for follow-up treatment immediately after hospital stay.

Relationship codes

If caring for a child or a person who is unable to care for himself due to health reasons, the doctor indicates a code indicating the relationship between the patient and the family member caring for him:

• 38 – mother;
• 39 - father;
• 40 – guardian;
• 41 – trustee;
• 42 - another relative.

What does the code “other 31” mean on a sick leave certificate?

Using the numerical designations included in the “other” section, the doctor can convey additional information

about the state of human health.
So, if the column contains code 31
, this means that the person did not have time to recover and cannot continue to work. The presence of such information in the document may result in the opening of an additional sick leave.

Having received a document containing the numerical designation 31, the employer is obliged to provide compensation in the prescribed manner, regardless of the fact that the person has not yet returned to work. A sick leave sheet containing this code is considered closed. However, the law does not fix the total number of temporary disability certificates. The employer is obliged to pay

every document that the employee brings. It will not be possible to evade this responsibility.