ABNs: Game of Musical Diagnoses Leaves Patient Without Chair

Article Overview

This article examines common ABN and Medicare billing problems that can arise after a denied claim, especially when specialists and referring offices disagree about diagnosis support and documentation. It is relevant to physician office billers, coders, and practice managers who handle Medicare claims, secondary insurance billing, appeals, and patient liability issues. The article also addresses the risks of revising claims without adequate documentation and the operational tension that can result between practices and referral sources.