Health Information Management

Distinguish between ABNs for covered, noncovered Medicare services

APCs Insider, March 5, 2010

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Starting in April, when a patient receives an ABN, coders and billers will need to determine whether it’s because Medicare never covers the given service or because the service is covered but was not medically necessary for the patient.
CMS hasn’t really changed ABN requirements, 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,” says Hoy. “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.”
Continue reading “Distinguish between ABNs for covered, noncovered Medicare services” on the HCPro Web site. Briefings on APCs subscribers have free access to this article in the March issue.

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