Health Information Management

Distinguish between ABNs for covered, noncovered Medicare services

Briefings on APCs, March 1, 2010

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CMS has not really changed the requirements for ABNs, says Kimberly Anderwood Hoy, Esq., CPC, director of Medicare and compliance at HCPro, Inc., in Marblehead, MA. “If you don’t think a service is covered because of medical necessity, you still do an ABN like you always have,” Hoy says. “But for statutorily noncovered services that do not require an ABN, you may now voluntarily give one. CMS did not allow you to give one in these circumstances before.”

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