Neurology & Pain Management Coding Alert

Question: I have heard that the new advance beneficiary notice makes the notice of exclusions from Medicare benefits obsolete. Is this true?

North Carolina Subscriber

Answer: You heard right. CMS expects the advance beneficiary notice (ABN) to eliminate any widespread need for the old notice of exclusions from Medicare benefits (NEMB) form in voluntary notification situations.

In case you weren't familiar with exactly when you were supposed to use the ABN rather than the NEMB, keep in mind that in the past, you only used ABNs for procedures or services that Medicare was not likely to provide coverage for.

Originally, ABNs didn't apply to procedures or services that were statutorily excluded from Medicare benefits. That was where the NEMB came into play -- you used it for services that Medicare never covered.

The revised and updated ABN -- which became effective March 3 -- not only incorporates the NEMB form but also replaces both the previous ABN-G (for physicians) and ABN-L (for laboratories).