Unfortunately, Medicare does not cover IUD's. If a patient with Medicare wants to have an IUD inserted, you must have them sign an ABN form, even if they have a secondary that will cover it, in order to bill Medicare and the patient. With out notifying the patient, that it is a non covered service, you can not bill the patient. If the patient only has Medicare, you will have them sign an ABN and it is appropriate for you to request payment in full at the time of service.
You CAN NOT choose to have them NOT sign an ABN and then NOT bill Medicare if you are contracted and accept assignment with them. This is an incorrect billing practice. The patient can choose for you not to bill Medicare, but they have to check mark that box on the ABN form. You must still have them complete the ABN form.
Hope this helps. If you have any additional questions, please feel free to email me.