The Medicare Advance Beneficiary Notice (ABN) form has had an update to the instructions on how the form is to be used. The form itself has not been updated from the revised version published this year with the expiration of Jun 2023.

The Medicare ABN is required as a notice to any Medicare patient when the covered services (spinal CMT for chiropractors) will not be covered. This notice is required for the patient can make an informed decision of their liability for services normally covered by Medicare. Essentially for maintenance care of spinal manipulation. While it too may be used for informing the patient about excluded services the intent is for when covered services are not payable.

The updated form is in the document library for those who have The HJR Digital Coding and note there are 2 versions one for Par providers and one for Non-Par providers. If you are a member of the HJ Ross Network, simply contact us for the updated version.

Beginning on October 14, 2021 (“Effective Date”), suppliers must use the updated and revised ABN guidelines found in Chapter 30, Section 50 of the Medicare Claims Processing Manual. A few of the key provisions that were revised include: (i) the events that trigger the furnishing of an ABN, (ii) general notice preparation requirements, (iii) the furnishing of ABNs to dual eligible individuals, and (iv) the period of effectiveness.

The latter applies to the time frame of an ABN which was up to one year but now may extend beyond if under the same care plan.

Providers and suppliers are required to notify a beneficiary in advance of furnishing an item or service when it is believed that the item or service will likely be denied by Medicare. The ABN establishes beneficiary knowledge of non-coverage and allows the beneficiary to choose whether to receive the service as an informed consumer.

Members of the HJ Ross Network are welcome to contact our expert Sam Collins for more complete details. If not a member go to our main page here to sign up.


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