Oncology & Hematology 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 that Medicare might not cover.

Originally, ABNs didn't apply to procedures 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).

No need to worry: Although Medicare carriers began accepting the new ABN form as of March 3, CMS has implemented a six-month transition period. Thanks to this, you aren't required to submit the new form until Sept. 1.

Where to look: You can locate the ABN form and instructions for its use on the CMS Web site at http://www.cms.hhs.gov/BNI/02_ABNGABNL.asp.