DecisionHealth, DecisionHealth - 2009 Issue 11 (November)

Physicians spared from tough new ABN GA modifier rule, at least for now

Institutional providers will need to be much more careful in using Medicare's Advance Beneficiary Notice of Non-coverage (ABN) form in 2010, thanks to a tough new rule CMS recently unveiled. Transmittal 1840 to the Medicare Claims Processing Manual, released Oct. 29, isn't explicitly clear about whether it applies to hospitals/facilities or physician practices, but CMS does intend for it to affect only institutional claims (i.e. services done in hospitals and facilities), an agency official confirms in an interview with Part B News.

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