LNCtips.com: ABA Billing Codes

Most medical malpractice insurance companies require law firms to use billing codes created by the American Bar Association (ABA). As a new legal nurse consultant, you'll want to review these codes to know if you should use them.

The billing codes, officially called the Uniform Task-Based Management System, were developed to provide standardized billing practices for law firms. There are different billing codes for different types of law firms, such as those involved in bankruptcy or transactional work.

The codes for medical malpractice litigation are the most complex. There are codes for the various stages of the litigation process (case assessment, pre-trial pleadings and motions, discovery, trial, and appeal), expenses (copying, postage, witness fees, etc.) and activities (research, communication, drafting reports, etc.). For a complete list of codes, see below.

Attorneys, paralegals, and legal nurse consultants bill for their time using both an L Code and an A Code For example, let's say that my case involves an allegation that my firm's physician client failed to appropriately monitor a patient's Coumadin levels, resulting in a hemorrhagic stroke. When I speak with an expert to determine his or her opinion, I bill my time as L130 (Experts/Consultants), A108 (Communicate - Other External). When I draft a report about the expert's expert opinion, I bill L130 (Experts/Consultants), A103 (Draft/Revise). When I review the physician client's medical records specifically for anticoagulation, I bill L120 (Analysis/Strategy), A104 (Review/Analyze).

After I decide which code to use, I add a description of the task for which I'm billing.  For the first example above I bill my time as L130, A108 - Telephone conference with our cardiology expert, Dr. Hart, about his opinion related to his review of plaintiff's anticoagulation therapy. For the second example, my billing reads L130, A103 - Drafted summary of Dr. Hart's review opinion related to effectiveness of plaintiff's anticoagulation therapy. For my third example, I bill as L120, A104 - Analysis of medical records of Dr. XYZ to correlate Coumadin dosing to laboratory results.

Even though there are both L and A codes for document and file management, insurance companies won't pay for organization of medical records because the companies view it as a clerical task. Clerical and secretarial duties aren't reimbursable.   Insurance companies WILL pay for other expenses related to the case such as copying, printing, long-distance phone calls, etc. as shown in the Expense Codes below.

Under what circumstances should LNCs use ABA billing codes? Legal nurse consultants who work in defense law firms use these codes, so familiarize yourself with them if your goal is to work in a defense law firm or a medical malpractice insurance company. If you work as an expert, independent, or in-house LNC for a plaintiff firm, you can relax; these codes don't apply to you since plaintiff firms don't work with insurance companies. If you're an expert for the defense, your time will be submitted to the insurance company as an expense so you don't have to worry about the codes either.  However, if you're an independent who works for the defense, check with your clients. They may either bill your time as an expense or ask you to bill using L Codes and A Codes.

You now know how to bill using ABA codes!

Select one code from each column.

For expenses, if applicable, select those that are appropriate.

...Katy Jones