Software Specific Questions:
#8 What does ABN mean?
ABN stands for Advanced Beneficiary Notification. An ABN must be signed prior to providing a Medicare service or test to document that the patient is willing to assume responsibility for payment of services that Medicare may not cover when subject to either National or Local Coverage Determinations (NCD) or (LCD). By obtaining a patient signature the provider can later bill the patient, when the services are denied by Medicare.
Here's how it works:
------CMS releases an NCD or LCD that includes a set of affected CPT/HCPCS codes
------These codes may require a specific ICD code to be listed with it for billing
----------(medical necessity code pair)
------In these cases, if the ICD code is not listed on the bill the patient MUST SIGN an ----------ABN.
If they do not, and you provide the service/test, medicare will deny payment and you will not be able to bill the patient for the cost.

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