Neurosurgery Coding Alert

An advance beneficiary notice (ABN) is a written notice to a Medicare beneficiary that Medicare may not cover a particular service or procedure. By signing the waiver, the patient acknowledges that he will pay for the procedure or service if Medicare does not.

The ABN must clearly identify the service/procedure the surgeon plans to provide, the estimated charge for the service, and state why Medicare may not provide coverage. The ABN affects only those services/procedures you-ve specifically listed. You should not give an ABN to a beneficiary if you have no specific, identifiable reason to believe Medicare will not pay (i.e., a -blanket ABN-). In all cases, you should provide the patient with a completed and signed copy of the ABN for his records.

Helpful hint: To obtain a standardized, sample ABN, visit the CMS Web site www.cms.gov and use the -search- function to locate form CMS-R-131-G.