You must be specific as to why Medicare will not pay. Most of the time it is a matter of a limited number of services per a specified time period (which the patient never knows if they have had) or diagnosis specific coverage. Here are a couple of examples that we use. We use ABNs for Bone Density Tests. For the reason we have "Medicare will only pay for bone density test every two years". We also use ABNs for Trigger Point Injections. For these we have "Medicare only pays for trigger point injections for specific diagnosis. Your diagnosis is not one of the diagnosis that Medicare as approved for coverage of this procedure". Hope this is helpful.
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