Centers for Medicare and Medicaid Services (CMS), unveiled on March 3, 2008, the new ABN (Advanced Beneficiary Notice), and with the deadline several months away, you should begin taking steps to put it into practice.

The new ABN replaces the previous ABN-G (for physicians) but also includes the Notice of Exclusions from Medicare Benefits (NEMB) form.  Centers for Medicare and Medicaid Services (CMS), state that the new combined form will “eliminate any widespread need for the NEMB in voluntary notification situations”, according to the new ABN form instructions document.

Key features of the new form are:

♦  A new office title, “Advanced Beneficiary Notice of Noncoverage”, which clearly conveys the purpose of the notice

♦   Replaces the ABN-G and ABN-L

♦   Can be used for voluntary notifications, in place of the Notice of Exclusion from Medicare Benefits (NEMB)

♦   Has a mandatory field for cost estimates of the items/services at issue

♦   Includes a new beneficiary option under which an individual may choose to receive an item/service, and pay for it out-of-pocket, rather than have a claim submitted to Medicare

In the past, the ABN was only for procedures that Medicare might not cover but didn’t apply to procedures that were statutorily excluded from Medicare benefits. The NEMN is used for services such as cosmetic surgery or the normal preventive annual well-woman examination, which Medicare does not cover.

The form, in English and Spanish versions, and notice instructions are now posted on the Beneficiary Notice Initiative web page at www.cms.hhs.gov/bni

Please remember that the ABN-G and ABN-L will no longer be valid beginning March 1, 2009.

If you need any additional information on this article or a summary of the 2009 ICD-9 changes please contact Cindy Tipton at Cindy_Tipton@MED3000.com.

For a printable version, click: CCNewsletterOctober2008

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