[Congressional Record (Bound Edition), Volume 149 (2003), Part 3]
[House]
[Pages 2942-2943]
[From the U.S. Government Publishing Office, www.gpo.gov]




                               ABC CODES

  The SPEAKER pro tempore. Under a previous order of the House, the 
gentleman from New Jersey (Mr. Pallone) is recognized for 5 minutes.
  Mr. PALLONE. Mr. Speaker, the billing code system in the United 
States permits insurance reimbursement for health services and 
facilitates review of patient access and utilization of benefits.
  Mr. Speaker, the way we determine health policy, evaluate health care 
services and codify those services for reimbursement impacts our health 
care system in dramatic ways. In health care reimbursement, if there is 
no code for the product, it will not get reimbursed.
  Many Americans use complementary and alternative health care 
procedures, including nursing, chiropractic, acupuncture, naturopathic 
medicine, nutritional and botanical therapies. Too

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often there is no insurance reimbursement or inadequate reimbursement 
for these health-promoting services. And one reason is because there is 
no standardized tool to code these services and products. As a 
consequence, those who can afford it pay out of pocket and those who 
cannot are denied access.
  Right now the Current Procedure Terminology code, or CPT codes as it 
is called, is the only approved coding standard available for insurance 
reimbursement. It is geared strictly to services provided by physicians 
and does not have the capability to represent services by other 
licensed providers including nurses. The CPT codes cover only about a 
quarter of all health care services used by Americans, leaving out 
three quarters of all health care products and services used to stay 
healthy and prevent disease. This creates critical gaps in knowledge 
about the health care marketplace.
  On January 16, Health and Human Services Secretary Thompson 
authorized a pilot test of a new coding practice in accordance with the 
provisions and regulations governing the Health Insurance Portability 
Act that facilitates electronic transactions. These new codes 
supplement CPT codes and support tracking, measurement and analysis of 
the economic and health outcomes of complementary and alternative 
medicine, nursing and other forms of integrated health care. We have 
the opportunity as a result of this action to make major strides in 
addressing pressing issues in health care, accessibility, quality and 
cost management.
  Mr. Speaker, this new technology is a set of alphabetic codes, called 
ABC codes, that function in a manner similar to the bar codes in the 
retail industry. This innovative new technology can provide us as 
health policy-makers with a more complete and accurate picture of the 
way U.S. health care is managed, financed, and delivered in terms of 
what works and what does not.

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  Head-to-head comparisons of conventional, complementary and 
alternative care are necessary to identify and advance the most health-
promoting and cost-effective health care practices.
  Mr. Speaker, I learned about the ABC codes because they address many 
health care services that have been largely ignored and undervalued and 
because studies show it is much more cost-effective to prevent disease 
than to treat it after it has developed.
  The developers of ABC codes have designed ABC codes to fit into 
existing health care data fields, software application and information 
systems. So the cost and burden of implementation is small, but the 
benefits are large, and ABC codes help payers identify when 
reimbursement is justified as it relates to whether the provider is 
licensed under State law.
  Mr. Speaker, I urge everyone to pay close attention to this pilot 
program to learn of the value of integrating complementary health care 
and assisting us in developing a model of care that is more cost-
effective and health promoting.

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