November/December 2004
Brandi Schlossberg

Auto insurance uses ABC codes

Mitchell Medical, a leader in the field of claims-processing software for auto injuries, will incorporate Alternative Link's ABC codes – integrative health-care codes – into its claims-management software during 2005.

"The partnership between Alternative Link and Mitchell will mean auto-insurance companies can pay alternative-medicine providers more accurately for the services they provide people injured in an automobile accident," said Tom McCarthy, senior vice president and general manager of Mitchell Medical. "Up to 55 percent of those injured in an automobile accident now use some form of complementary and alternative medicine."

ABC codes include 4,000 alphabetic codes to describe various complementary health-care techniques, with about 200 codes related to types of massage (see Table Talk, July/August, "Insurance codes focus on complementary care"). The codes were created to fill in the blanks left by the Current Procedural Terminology (CPT®) codes, which were developed by the American Medical Association and are widely used in insurance billing.

Among CPT® codes, there is only one used to describe basic Swedish massage, with no specification as to whether a session consisted of craniosacral therapy, deep- tissue massage, Rolfing, or some other form of bodywork.

"Many of our clients had been unaware that this information could be available to them," said Michele Iacobacci, senior director of health-information management for Mitchell International.

Synthia Molina, CEO of Alternative Link, said the use of ABC codes will help save auto-insurance companies from the hassle of investigating vague claims, and will ensure that complementary practitioners receive payment for their services.

"CPT® codes don't describe non-physician care very well, so the claim may have to be investigated or even denied," said Molina.

ABC codes, which describe complementary care in detail, will allow more specific information to be conveyed through the billing process, which can be done on paper or electronically.

In January 2004, staff from Alternative Link attended a meeting of 75 managers from auto-insurance companies that use Mitchell Medical's software, to train them in the use of ABC codes.

"They were energized and enthusiastic to learn that this is in the pipeline," said Iacobacci. "Until now, they've been sort of shooting in the dark."