FAQs For ABC Codes
1: What are ABC codes?
ABC codes are five letters that represent about 4,500 healthcare products and services.
2: What is an example of an ABC code for a healthcare service?
Postpartum perineal care each 15 minutes
Caring for a client’s/patient’s postpartum perineal skin to relieve discomfort and/or promote her perineal healing. Service is billed in 15 minute increments.
3: How are ABC codes used within the healthcare system?
ABC codes can be input into a computer as shorthand to communicate what the provider is doing to treat the patient and also the cost of a specific treatment. Conventional doctors have been using medical codes since 1968 to document their care and get paid for that care. ABC codes were developed to supplement medical codes for the same purpose.
4: What types of professional healthcare services are represented by ABC codes?
Clinical Nurse Specialist (all specialties)
Clinical Social Worker
Doctor of Chiropractic
Doctor of Oriental Medicine
Doctor of Osteopathy (holistic)
Marriage and Family Therapist
Midwife (Certified and Lay)
Medical Doctor (holistic, all specialties)
Nurse Midwife Nurse
Nurse Practitioner (all specialties)
Registered Nurse (all specialties)
Spiritual Advisor/Pastor/Priest (all faiths)
Spiritual Nurse (all faiths)
ABC codes also represent services from providers such as herbalists, physical trainers and yoga instructors who are not designated as licensed healthcare providers under state laws.
5: Will other areas of healthcare be addressed by ABC codes?
Yes. ABC codes can be developed for any healthcare service or supply that is not illegal and there is no cost to apply. (link to the code request already provided)
Companies who develop proprietary products and services may also apply for ABC codes for a fee. Click here for more information.
6: Who uses procedure and supply codes, like ABC codes?
Virtually every practitioner and organization in the healthcare system uses codes for medical record keeping, practice management, billing, processing insurance claims and for designing and managing insurance benefits. Researchers also use procedure codes for comparative effectiveness studies.
7: What other types of codes are used to manage healthcare?
a: ICD-10 diagnostic codes are used to document health problems or diseases being treated. Diagnostic codes are always required when filing insurance claims.
b: Many other code lists are used to manage healthcare claims. These can be found at: http://www.wpc-edi.com/reference/
8: What is an RVU and why are RVUs important?
RVUs (Relative Value Units) establish the financial worth of any healthcare service or supply. RVUs are assigned to procedure and service codes to manage insurance reimbursement, managed care or provider contracting, utilization studies, practice management fees, electronic claims payment processing, outcomes research and a variety of actuarial analyses. Conventional medical codes have relative value units. The Relative Value Scale Update Committee for conventional medical codes is managed by the American Medical Association in collaboration with the Centers for Medicare and Medicaid Services.
9: How are RVUs for ABC codes assigned?
ABC Coding Solutions licenses ABC codes to Relative Value Studies, Inc. (RVSI) to develop RVUs for ABC codes. RVSI conducts surveys with healthcare practitioners to establish RVU values. RVSI publishes Relative Values for Integrative Health Using ABC Codes. More information about can be found at www.rvsdata.com.
10: Are ABC codes compatible with other codes and systems in use today?
Yes. ABC codes can be used as insurance claims are filed in conventional claims filing systems to supplement required medical codes. ABC codes are five characters in length, just like the codes used to file healthcare claims. Most claims processing and payment systems can use ABC codes with little or no modification. Standard electronic data exchange systems are required to provide a field where conventional medical code information can be supplemented. ABC codes and short descriptions fit into this field.
11: Who can use ABC codes?
Anyone can use ABC codes to better document care. Providers who file healthcare insurance claims can use ABC codes to supplement any medical procedure code as claims are filed.
12: Do you offer help for using ABC codes?
Providers can purchase Superbills that map ABC codes to the medical codes required for billing. We also provide consulting service to private practices, clinics, hospitals and insurers wishing to better document services from the health professions whose services are supported by ABC codes.
13: How are ABC codes developed?
ABC codes are developed using precise descriptions of care. Code development is managed in an open and unbiased manner that reflects the official training, practices, vocabularies and terminologies of healthcare professions.
Ready to buy our ABC Coding Manual?
Grab a copy of our Coding manual today. We have the hardcopy available as well as the digital download and combination ABC Coding Manual and Superbill.