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Non-Covered Services for Part B

  1. #1
    Location
    South Salt Lake City
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    Post Non-Covered Services for Part B
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    I am trying to get my ABN form done and I can't seem to find the list of Non-Covered Services for Medicare. Can anyone point me in the right direction so I can get this darn form done. Thanks, Jody

  2. #2
    Location
    North Carolina
    Posts
    3,126
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    See if this is what you're looking for...


    http://www.cms.hhs.gov/manuals/Downloads/bp102c16.pdf
    Last edited by RebeccaWoodward*; 11-17-2009 at 09:14 AM. Reason: spelling

  3. #3

  4. #4
    Location
    South Salt Lake City
    Posts
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    where in this exactly am I looking?

  5. #5
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    Non-covered services do not require ABNs. ABNs are only for services that are normally covered but due to some reason they are expected to be denied for this service on this patient.

    An example would be if a patient requests a normally covered test be done but does not have an acceptable dx for medicare. In this case you would tell the patient up front with the ABN what the service is, why you don't think Medicare will cover it, and the estimated cost. The patient then gets to decide whether or not they want to recieve the service based on the fact they will probably have to pay for it.

    CMS provides the ABN form, you just fill it out on a case by case basis. There is no list of services, that I am aware, like you are asking for. What we generally do is keep the LCD/NCDs of the services we provide on hand, so if there is a question they can look it up and determine whether or not an ABN is needed.

    Laura, CPC, CEMC

  6. #6
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    We use ABN forms here since a patient will sometimes have more than the permitted amount of mammos, carotid US or dexa scans done than Medicare will allow in a certain time frame. The patient is told when signing the ABN that it may not be covered. Medicare puts a limit on these screening exams. I found the info I needed from that Medicare website I had sent you. We also used it on certain CPTs when I worked Dermatology and Chiropractic. I'm sure if you let us know what medical area you work in someone can help you with exactly what you need.

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