Primary Care Coding Alert

ABNs:

What to Change, What to Leave Alone

Published on Fri Mar 26, 2004

Got an itch to make a switch on an ABN? Proceed with caution

When it comes to manipulation of its general ABN (or ABN-G) form, Medicare is like a stern but understanding parent: unbending on certain issues, yet sensible enough to be flexible when the situation calls for a slight alteration.

If you make a change to an area Medicare has deemed "off-limits," the ABN will likely be defective, said Thomas Bartrum, JD, attorney at Baker Donelson Bearman & Caldwell in Nashville, Tenn., at the American Health Lawyers Association's 2003 Institute on Medicare and Medicaid Payment Issues.

Follow These 5 Rules

Bartrum said each ABN-G also has some areas that the provider can -- and in some cases should -- customize. When you file an ABN:

The header should be altered to include your practice's logo (if it has one), practice name, address and telephone number.

The type should all be in 12-point Arial or Arial Narrow font. Believe it or not, use of other fonts or point sizes can render an ABN defective.

The "Items or Services" box should be expanded if the space provided is not adequate.

The "Because" box should be expanded if the space provided is not adequate.

All captions on the ABN should be left alone. Don't make any changes to Medicare's text on the form; you can alter it only for space, not content.

Warning: Always use caution when tinkering with an ABN. While Medicare allows ABN alteration, under no circumstances will it accept an ABN of more than one page. It's OK to print an ABN on legal-size paper to give yourself more space, but make sure you're submitting only a single sheet.

Do not alter any area of the ABN form not mentioned in this article, Bartrum said. Fill those areas out completely and do not change them for any reason -- unless your intention is to render the ABN useless. (For complete instructions on proper use of ABNs, visit the Web site www.cms.gov/manuals/pm_trans/ab02168.pdf.)