Significance:

ABC Coding is a standardized multidisciplinary coding system that is recognized by the American Nurses Association as supporting nursing practice. NACNS has been working with ABC Coding Solutions-Alternative Link, Inc, to validate ABC codes for CNS practice.

Background/Design:

Using nationally standardized codes, such as the ABC codes, facilitates CNSs fulfilling their responsibilities for documenting interventions in a reportable manner. Codes assist CNSs to document productivity and quality in the work setting, develop billing fees for CNS practice, and generate claims to insurance payment organizations. ABC codes are supported by references to the laws in each state to ensure that the care represented by each ABC code is within the legal scope of practice of CNS Practice.

Methods:

The presentation will provide an overview of the ABC Coding taxonomy and describe how codes can be used to describe CNS practice. Specific examples for acute and nonacute settings will be provided. The method for determining a fee structure using relative value units will be discussed.

Findings:

At the end of the session, the learner will be able to identify ABC codes for CNSs use in acute and nonacute settings and describe an appropriate fee associated with ABC codes for any practicelocation or reimbursement contract using the relative value unit system.

Conclusions:

CNSs who currently bill for interventions typically useCPT or HCPCS II codes, which are codes primarily used to describe medically directed care. Using codes specifically developed forand validated by CNSs will make CNS interventions visible and will support the productivity and value of CNSs within the healthcare system.

Implications for Practice:

By using ABC codes, CNS interventions will be visible to policy makers. Coding for CNS practice will enable payers to meet consumer demand for greater access to CNS services. Payers will have ability to identify cost-effective options to medical models of care. Graduate programs should consider including the use of codes for tracking productivity and quality and for billing.