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ABN Policy for Ortho

  1. #1
    Modesto, CA; Central Valley Chapter
    Default ABN Policy for Ortho
    Medical Coding Books

    I am wondering if anyone has a policy on getting ABNs signed in an orthopedic office. The only LCD I can find that might pertain is ordering MRIs on the lumbar. Other than that I find a couple on supplies.

    Does anyone have a policy that they would be willing to share?

    Tina Reich, CPC, CPC-I, CEMC

  2. #2
    Lewiston, Maine
    The ortho practice that I work for does use ABN's for our Medicare patients. In my office we mostly just use them for DME and gortex casting supplies. I would suggest checking out your local Part B website and finding out what their requirements are. States vary by carrier so I really don't think anyone else's policy will help you. Check your DME carrier denials and that should be a good starting point. Look for the "CO" messages, contractual obligations.
    The LCD's for your MRI's will help you. If a patient is are having an MRI for a different diagnosis code then what is listed on the LCD then you know that they wouldn't be covered and will require an ABN.
    Catherine Nolin, CCS, CPC, CGSC

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