Primary Care Coding Alert

Question: I’m looking at an advanced beneficiary notice (ABN) form and see seven separate blanks labeled “D.” Does the provider need to fill in each field or can they just write the specifics in the large box?

Colorado Subscriber

Answer: It’s important to fill in every D field — all seven! The Centers for Medicare & Medicaid Services (CMS) says the ABN form is not considered valid unless all blank “D” fields are completed.

The D field is where the provider might describe the item, service, laboratory test, test, procedure, care, or equipment that they believe Medicare may not cover. If the service or item may be partially covered, the provider should specify the component that might be denied. However, a term bundling several supplies, like “wound care supplies” is probably OK; CMS says that an itemized list of each supply is not usually required.

In cases when the patient would need repeated or continuous care that might be denied, such as repeated blood draws to monitor voluntary hormone replacement therapy, whoever is filling out the form for your practice should specify the frequency or duration of the items or services you expect to be denied.

Here are the full instructions for filling out ABN forms.

Rachel Dorrell, MA, MS, CPC-A, CPPM, Development Editor, AAPC