from the pages of PATIENT ACCESS WEEKLY ADVISOR

EMAIL THIS PAGE FORMAT FOR PRINTING SUBSCRIBE

CMS states that it will provide a few versions of the new form: a generic ABN and alternative versions with certain blanks completed for “those not wishing to do additional customization as permitted” (including laboratory illustrations). If customization is performed, you must print it on one page—either letter- or legal-size paper.

There are 10 blanks that you must complete, each of which has a corresponding alphabetical label on the form. CMS recommends that if the notifier customizes the form, the labels should be removed.

CMS reiterates that the new ABN is approved by the Office of Management and Budget and may not be altered except as stated in the instructions for implementation.

The overall process and notifier(s) responsibilities haven’t changed. The ABN must be given to beneficiaries in the Original Medicare Program to convey that Medicare is not likely to provide coverage in the specific case. It must be provided in advance of the item, test, or service.

“Notifiers include physicians, providers (including institutional providers like outpatient hospitals), practitioners and suppliers paid under Part B, as well as hospice providers and religious non-medical health care institutions (RNHCIs) paid exclusively under Part A,” according to the instructions.

The revisions are part of an ongoing process to subject the form to comment and reapproval every three years. CMS will issue the new detailed instructions on the use of the ABN in the online Medicare Claims Processing Manual, Publication 100-04, Chapter 30, prior to the implementation deadline.

Note: Tip provided by Bill Malm, RN, ND