Reason’s to Use an ABN for Therapy Services: Part 2

June 8, 2015
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Rick Gawenda
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In last week’s article, I provided one of the main reasons when a provider would need to issue an advance beneficiary notice of noncoverage (ABN) to a Medicare beneficiary receiving outpatient therapy services. To see last week’s article, click HERE. In today’s article, I am going to explain why a provider would need to issue an ABN to a Medicare beneficiary that requires iontophoresis as part of their therapy plan of care.

First, lets answer the question “Does the Medicare program cover iontophoresis”? The answer is yes. Nationally, the Medicare program does cover and pay for iontophoresis. So you might be asking yourself then why if the Medicare program covers and pays for iontophoresis would I need to have a Medicare beneficiary that requires iontophoresis as part of their therapy plan of care sign an ABN? Great question! The answer is because some of the Medicare Administrative Contractors (MACs) that process your therapy claims have decided that iontophoresis is

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  1. if dry needling is not a covered benefit under Medicare why would you do a Medicare ABN verses just going a Voluntary ABN????

    1. Great question! This is because nationally, CMS does not state it is not a covered benefit. Rather, MACs are choosing not to pay for it saying in many cases, dry needling is experimental/investigational.