Cardiology Coding Alert

This is how the ABN form should changeCMS has unveiled its new advance beneficiary notice, and even though the hard deadline is several months away, you should take steps now to put it into practice.Good news: The new ABN not only replaces the previous ABN-G (for physicians) but also incorporates the notice of exclusions from Medicare benefits (NEMB) form. CMS expects this new, combined form to "eliminate any widespread need for the NEMB in voluntary notification situations," according to the new ABN Form Instructions document.The ABN's previous purpose: ABNs were previously only for procedures that Medicare might not cover and didn't apply to procedures that Medicare benefits statutorily excluded. You were able to use the NEMB for services that Medicare never covered such as cosmetic surgery or an annual well-woman examination (99381-99397, Preventive medicine services).Now CMS will accept the new ABN form for either purpose, noting in its ABN Instructions that "the revised version of the ABN may also be used to provide voluntary notification of financial liability."Don't worry: Although Medicare carriers began accepting the new ABN form as of March 3, CMS has implemented a six-month transition period. Therefore, you aren't required to use the new form until Sept. 1.Although the ABN form has changed, many of the previous ABN "best practices" remain the same. Following is a quick look at three important ABN facts.All Hail the Importance of the ABNIf Medicare does not consider a patient's upcoming procedure medically necessary, but the patient still wants you to perform the service, an ABN will let the patient know that he may be responsible for paying the non-covered portion.ABNs help patients decide whether they want to proceed with a service even though they might have to pay for it. A signed ABN allows you to directly bill the patient if Medicare refuses to pay. Without a valid ABN, you cannot hold a Medicare patient responsible for the denied charges, says Kara Hawes, CPC-A, coder with Advanced Professional Billing in Tulsa, Okla. In other words, "The patient has to sign the ABN form at the time of service, otherwise the form is not valid," Hawes says. "When the claim is denied without an ABN, Medicare will not allow you to be reimbursed for the service or collect money from the patient."Clarify the ABN to the PatientABNs help the patient understand her options. Once you have completed the ABN and discussed it with the patient, she can: 1) sign the ABN and assume financial responsibility for the procedure in question; 2) cancel the procedure; or 3) reschedule the procedure or service for a future date when she can afford it, or when Medicare may cover the procedure.Catch this: "Medicare is going to [...]