Advanced Beneficiary Notice (ABN) as Applied to the IPPE (Rev. 1615, 01-05-09)

by  Jared Staheli
July 6th, 2015

If a second IPPE is billed for the same beneficiary, it would be denied based on Section 1861(s)(2) of the Act, since the IPPE is a one-time benefit, and an ABN would not be required in order to hold the beneficiary liable for the cost of the second IPPE. However, an ABN should be issued for all IPPEs conducted after the beneficiary’s statutory 6- month period has lapsed since based on Section 1862(a)(1)(K), Medicare is statutorily prohibited from paying for an IPPE outside the initial 6-month period under the MMA of 2003. Effective for dates of service on or after January 1, 2009, an ABN should be issued for all IPPEs conducted after the beneficiary’s statutory 12-month period has lapsed since based on Section 1862(a)(1)(K), Medicare is statutorily prohibited from paying for an IPPE outside the initial 12-month period under the MIPPA of 2008.

References:

Advanced Beneficiary Notice (ABN) as Applied to the IPPE (Rev. 1615, 01-05-09). (2015, July 6). Find-A-Code Articles. Retrieved from https://www.findacode.com/articles/advanced-beneficiary-notice-abn-as-applied-to-the-ippe-rev-1615-01-05-09-27016.html

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