Medicare Compliance & Reimbursement

Effective March 1, labs and physician practices must use the new combined ABN/NEMB. The Sept. 1 deadline for implementing the new ABN has come and gone -- but if your practice hasn't complied with the new form yet, take heart. CMS changed the deadline at the last minute, now allowing practices to wait until March 1, 2009 to begin using the revised advance beneficiary notice. Earlier this year, CMS unveiled its new advance beneficiary notice (ABN). The new form not only replaced both the previous ABN-G (for physicians) and ABN-L (for laboratories), but also incorporated the notice of exclusions from the Medicare benefits (NEMB) form. OK If You're Already Using It Medicare carriers began accepting the new ABN form as of March 3, but CMS has extended the transition period, allowing you until March to prepare for the new form. The six-month extension was good news to practices that thought the Sept. 1 deadline was too soon. "I know that a few physicians I work with told me that their speciality societies were fighting the Sept. 1 deadline," says Randall Karpf of East Billing in East Hartford, Conn. "Changing forms like that, for a large clinic, is time-consuming and expensive," Karpf says. Use New Form for Voluntary ABN Last week, CMS issued a MLN Matters article regarding the new ABN, which reminds providers that they should use the new form for both mandatory and voluntary ABN situations. What this means: You must issue an ABN in certain circumstances, such as when you perform care that isn't usually considered reasonable and necessary to Medicare, but which your physician believes is necessary. However, ABN use is voluntary in other cases; for instance, if Medicare statutorily excludes the service (such as a facelift). Editor's note: To read the MLN Matters article outlining the details of the new ABN form, visit the CMS Web site at http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6136.pdf.