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Thread: Holistic Health Counseling

  1. #1

    Default Holistic Health Counseling

    AAPC: Back to School
    Has anyone ever done billing/coding for certified holistic health counselors? She is state licensed, but am unsure if this can actually be billed like when a patient goes to a naturopathic doctor for an office visit.
    Any help/ideas/suggestions would be appreciated!

  2. #2
    Join Date
    Apr 2007
    Columbia, MO


    There is a set of codes called alternative health codes you use insted of CPT codes. They are named ABC codes. You should contact individual carriers to see if they are accepted. Here is a blurb from an AHIMA article referring to ABC codes:
    Coding for Alternative Medicine
    Most of you are probably aware that codes exist in CPT and ICD-9-CM for some types of alternative medicine treatments. For example, CPT codes 97780-97781 describe acupuncture treatments, codes 90875-90876 and 90901-90911 describe biofeedback training, codes 98925-98929 describe osteopathic manipulative treatment, and codes 98940-98943 describe chiropractic manipulative treatment. In ICD-9-CM, codes 99.91-99.92 describe acupuncture, code 93.35 includes acupuncture with smouldering moxa, code 94.39 includes biofeedback in psychotherapy, and codes 93.61-93.67 describe osteopathic manipulative treatments.

    But how many of you are aware that a coding system has been developed exclusively for alternative medicine? The national alternative medicine codes were developed by Alternative Link, a privately held company that develops software to support alternative healthcare billing, reimbursement, and office management functions.

    Development of a coding system for alternative medicine began in 1996 and the main objective was to produce a system that would compatibly interact with mainstream medical billing systems and would facilitate third-party reimbursement decisions for selected forms of alternative medicine. Alternative Link holds the copyright for this coding system, which contains more than 4000 codes that describe what is said, done, ordered, prescribed, or distributed by providers of alternative medicine. Disciplines covered by this system include acupuncture, holistic medicine, massage therapy, homeopathy, naturopathy, ayurvedic medicine, chiropractors, and midwifery. The Nursing Intervention Classification (NIC) codes have also been incorporated into this coding system. The system was designed to give managed care organizations a tool to negotiate practitioner services in any state.

    The codes, known as ABC codes, are intended for use by all health plans, healthcare clearinghouses, and healthcare providers for processing all electronic transactions that require a code for an alternative medicine procedure, service, supply, etc. The coding system software facilitates linkage between providers, clearinghouses, and payers because it is fully ASC X12N compliant and incorporates an EDI-based architecture. A relative value unit was added to each code to allow fee capitation in any location. This information is built into CAM-Net™ products, which are distributed as:

    * an interactive database that supports managed care organizations wishing to build contracts with alternative providers
    * ASCII flat files for automated payer decision support
    * published resource materials for desk reference
    * lease agreements with clearinghouses for electronic claims routing

    The codes have been incorporated into the National Library of Medicine's Unified Medical Language System.

    Debra A. Mitchell, MSPH, CPC-H

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