Primary Care Coding Alert

Reader Questions:

Play It Safe for Screenings and Get Signed ABN

Question: A Medicare patient came to our office for screening laboratory tests in addition to his annual well visit. Do we need to ask him to sign an advance beneficiary notice (ABN) even though the patient should know that Medicare never covers the screenings?Answer: Yes, you should give the patient an ABN and explain that he will be responsible for covering the screening tests because Medicare doesn't.Don't assume that patients know which tests are for screening (and therefore not covered) and which are for diagnostic purposes. If you don't ask the patient to sign an ABN, you have no proof that the patient knew he was having a screening test and was financially responsible.Consideration: Sometimes your physician might provide a service that Medicare would pay under different circumstances. For example, 85025 (Blood count; complete [CBC], automated [Hgb, HCt, RBC, WBC and platelet count] and automated differential WBC count) sometimes might [...]
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in Revenue Cycle Insider
  • 6 annual AAPC-approved CEUs
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more

Other Articles in this issue of

Primary Care Coding Alert

View All