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Wiki Abn notice

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JJOHN0312

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Can an ABN notice be given from a facility OP to a patient for services that are covered and we know that they are covered?

Scenario: OP facility is collecting ABN on 83036 (A1C) lab test everytime a patient has this lab regardless of the diagnosis. Even if it is covered.

Please give any references.

Thank you!
 
Go to the Medicare website and look up ABN. If you are collecting the ABN then you must use the GA modifier for Medicare submission. You cannot do one or the other. The rules for ABN will show you that you cannot collect a ABN just because. The AN must specifically state the reason for the ABN such as service not covered for the diagnosis of ..... If you know it is covered then there is no reason to have the ABN.
 
Abn

I have the ABN booklet and see there are triggering events. I don't believe that this is correct either. Are there any legal ramifications for this?
 
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