Compensation for Occupational Injuries and Diseases Act, 1993 (Act No. 130 of 1993)Scale of FeesAnnual Increase in Medical Tariffs for Medical Service Providers - 2026Speech Therapy, Audiology & Acousticians Gazette 2026General Information7. Invoicing requirement on Medical Invoices for ICD-10 Codes |
As part of improved delivery service and efficiency, The Compensation Fund has implemented ICD-10 rules that must be adhered to when submitting medical invoices. This will be rolled out in a phased approach. The first phase currently active on the system is outlined below:
ICD-10 Validations
ICD-10 validations will apply in accordance with the national ICD-10 Phase 3 and Phase 4.1 requirements and include the following:
| • | Valid ICD-10 codes as per the SA ICD-10 Master Industry Table |
| • | Maximum level of specificity: ICD-10 codes must be valid at the correct 3-, 4-, or 5- character level |
| • | Valid ICD-10 primary codes (codes not valid as primary will be rejected) |
| • | Compliance with the dagger and asterisk rule |
| • | Compliance with sequelae coding rules |
| • | Age edits for ICD-10 codes with age requirements |
| • | Gender edits |
| • | All injury and poisoning codes must be accompanied by external cause codes |
Please ensure that you are familiar with the above requirements to avoid unnecessary claim rejections. The date and requirements for the next phase will be communicated in due course.