Different procedure than listed on ABN

PennyG

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Nursing staff called and verified procedure information as instructed by the provider, so they could have an ABN completed and signed prior to the procedure. Now that I have reviewed the procedure documentation, instead of an I&D, the procedure started as an I&D, then became more involved and ended up being an excision with layer closure.

My question is, can the ABN listing an I&D still be used or should we have completed another one when it was determined this would be a more extensive procedure.
 

Aperring

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Have a similar issue

The nurses in our cath lab are having the patient fill out an ABN for any possible cath procedure that may be done if the DX on the order does not support medical necessity for them just in case the procedure ends up being more extensive. I am looking for some documentation that either does or does not support this practice.
 
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Nursing staff called and verified procedure information as instructed by the provider, so they could have an ABN completed and signed prior to the procedure. Now that I have reviewed the procedure documentation, instead of an I&D, the procedure started as an I&D, then became more involved and ended up being an excision with layer closure.

My question is, can the ABN listing an I&D still be used or should we have completed another one when it was determined this would be a more extensive procedure.

What service was the ABN being used for specifically? I know it's an I&D, but was the ABN necessary because of lack of medical necessity or statutory exclusion...? I'm still looking for exact documentation to provide you links to, but I'm wondering if this could be considered an "emergent" situation which would allow more wiggle-room. Is the patient awake and aware of time and place or are they sedated or under anesthesia without the ability to make decisions? Depending on the status of the patient, if they are under anesthesia and can't discuss an ABN, I could see that possibly qualifying as "duress". If they are awake and alert, then that wouldn't work. Another question is what happened that caused the shift to the excision?

See page 4 under "Other Prohibitions", 2nd bullet down...
https://www.cms.gov/Outreach-and-Ed...NProducts/downloads/abn_booklet_icn006266.pdf


The nurses in our cath lab are having the patient fill out an ABN for any possible cath procedure that may be done if the DX on the order does not support medical necessity for them just in case the procedure ends up being more extensive. I am looking for some documentation that either does or does not support this practice.

See page 4 under "Routine Notice Prohibition"
https://www.cms.gov/Outreach-and-Ed...NProducts/downloads/abn_booklet_icn006266.pdf

Does this help?
 
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