Question: Our urology practice wants to start using nitrous oxide for in-office procedures such as Urolift, vasectomy, etc. I don’t know anything about billing this. Will insurance cover it or will the patient need to pay? New Mexico Subscriber Answer: Insurance will not cover administering nitrous oxide during a procedure. The patient will be responsible for payment and should pay up front. Ask the patient to sign an Advance Beneficiary Notice (ABN) acknowledging his agreement to pay. Explanation: An Advance Beneficiary Notice (also known as a waiver of liability) is a written document your office should give Medicare patients prior to authorizing and performing a procedure that you don’t believe Medicare will reimburse. The patient signs the form to confirm responsibility for payment.