Part B Insider (Multispecialty) Coding Alert

Does your practice have to be on the hook if a patient refuses to sign an ABN? No, says a recent question-and-answer from Medicare contractorNHIC.

“If the beneficiary demands the service and refuses to pay, the notifier should have a second person witness the provision of the ABN and the beneficiary’s refusal to sign,” the notification says. “They should both sign an annotation on the ABN attesting to having witnessed said provision and refusal.”

What if there is no one else available to witness? “The second witness may be contacted by telephone to witness the beneficiary’s refusal to sign the ABN by telephone and may sign the ABN annotation at a later time,” it says. “An unused patient signature line on the ABN form may be used for such an annotation; writing in the margins of the form is also permissible.”

This is supported by language in the Medicare Claims Processing Manual, which you can read at www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/clm104c30.pdf.