tci Outpatient Facility Coding Alert - 2013 Issue 7

Rehab Services: Don't Skip the ABN, or You Could Be Stuck With the Therapy Bill

Exception: Steer clear of an ABN when modifier KX applies. If you haven’t heard the latest changes regarding Advance Beneficiary Notices (ABNs), it’s time to get the scoop. A denied claim that was once your patient’s financial responsibility could become yours. Background: The American Taxpayer Relief Act of 2012 gave Medicare beneficiaries limitation of liability protections, starting Jan. 1, 2013, for therapy services that don’t qualify for an exception to the therapy caps. “At that point it was mandated that the therapist issue an ABN prior to delivering services over the cap, if there...

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