Orthopedic Coding Alert

Question: I was told by a colleague that there’s a new advance beneficiary notice (ABN) form that our practice is to be issuing as of August 31, 2020. Is this correct?

Ohio Subscriber

Answer: Prior to the COVID-19 pandemic, there were plans by the Office of Management and Budget (OMB) to issue a renewed ABN form at an August 31, 2020 deadline.

Refresher: The ABN is a notice given to Part B beneficiaries by providers to explain that a respective service is unlikely to be reimbursed by Medicare. In the event that Medicare denies the service, the patient will sign the form to agree that they are to be held accountable for the charges. Keep in mind that other commercial payers may also implement their own versions of the ABN.

Your practice currently has the option to implement the renewed ABN Form CMS-R131, but the Centers for Medicare & Medicaid Services (CMS) recently issued an updated notice to expand the deadline for the implementation of ABN Form CMS-R131 until Jan. 1, 2021. This allows practices that are struggling to implement new measures and practices some additional time before the renewed form becomes mandatory.

You can learn more about Form CMS-R131 at: https://www.cms.gov/Medicare/Medicare-General-Information/BNI/ABN.