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New Billing Codes May Include Training

ALBUQUERQUE, NM — Personal training clients may be one step closer to receiving insurance reimbursement for their sessions. The National Board of Fitness Examiners (NBFE) plans to submit ABC terminology and code requests to have personal training services included in the ABC Coding Manual for Integrative Healthcare for 2006, said Dr. Sal Arria, founder of NBFE. Alternative Link, an Albuquerque company, created ABC codes for documentation of services as well as electronic insurance billing.

Doctors file claims to health insurance companies using current procedural terminology (CPT) codes developed by the American Medical Association to document the services and procedures they perform. However, CPT often does not provide billing codes representative of integrative health care, according to Alternative Link. For example, the CPT codes offer just one code for massage therapy even though many types of massage can be performed — each of which vary in cost and level of practitioner expertise.

“ABC codes are designed to fill gaps where CPT leaves off,” said Heidi Rothenberg, marketing director for Alternative Link. “We support accurate coding of what [practitioners] are providing to support research, management and commerce.”

Doctors use the codes for medical record keeping, practice management and billing. Insurance companies use them to process claims and to help design and manage benefits. Research companies use the codes to help determine which treatments are most effective.

“Codes can be used for a lot of reasons, but if there aren't codes, it is hard to get your service added to insurance plans,” said Melinna Giannini, president and founder of Alternative Link.

That's why Arria wants personal training added to the ABC codes. “As personal trainers take on a more responsible role as allied health care professionals, their clients should get reimbursed for their visits with a personal trainer,” he said.

The NBFE is setting up a directory of personal trainers who have taken the NBFE exam. Once that directory is in place, it will serve as a referral source to promote personal trainers to the medical field, Arria said.

Once referrals become more commonplace, “that becomes a shoe in for [personal training clients'] ability to get reimbursed,” Arria said.

Alternative Link requested ABC codes be named a national Health Insurance Portability and Accountability Act standard in June 1998. Secretary Michael Leavitt of Health and Human Services is reviewing this request.

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