ABC Codes

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ABC Codes are five-digit Health Insurance Portability and Accountability Act (HIPAA) compliant alpha codes (eg. AAAAA) used by licensed and non-licensed healthcare practitioners on standard healthcare claim forms (eg. CMS 1500) to describe services, remedies and/or supply items used during patient visits. The codes contain both a short description and an expanded definition of the service, remedy and/or supply item. ABC codes were created and designed by ABC Coding Solutions [1].

ABC codes fill gaps in healthcare coding and the National Health Information Network (NHIN) that older medical code sets do not cover by describing care provided by all healthcare practitioners. They can also be used in conjunction with two-digit, alpha-numeric practitioner identifiers (eg. 1A) to identify the practitioner type (eg. chiropractor) providing the service. Additionally, ABC codes are supported by state legislative references regarding scope of practice and training requirements on a code, state and practitioner-specific basis.

ABC codes are a proposed solution and approach to accurately document care provided during each patient encounter as mandated by HIPAA.