Back   Provider's Report of Injury or Illness (004030X144)


The Provider's Report of Injury or Illness Implementation Guide describes the use of the ANSI ASC X12 Report of Illness, Injury or Incident (148) transaction set for the following business usage:
  • For a health care provider to report Report of Injury or Illness information regarding a work related incident to a claim administrator, employer or jurisdiction, in accordance with jurisdictional reporting requirements.
  • After creation by the health care provider, the Provider's Report of Injury or Illness may be exchanged between the claim administrator, employer or jurisdiction.

Primary Trading Partners

Trading partners include:
  • Health care providers
  • Claim administrators, such as third party administrators, carriers, self administered employers, and managed care organizations
  • Employers
  • Jurisdictions
  • Intermediaries


This is the first implementation guide for this business purpose.

Additional Information

Registered 2/8/2000
Transaction Set ID 148 Standard Version 004030
ASC X12 DM# Owning Group X12N/TG1/WG3