Current News

News

05/30/23

Renewed ABN Form

The Office of Management and Budget (OMB) has approved the Advance Beneficiary Notice of Noncoverage (ABN) form and instruction for renewal. In this article, I will provide the answers to the following questions:

Read More
11/19/22

Understanding the ABN for Outpatient Therapy Services

This 1-hour webinar will teach participants when they can and can’t issue an advance beneficiary notice of noncoverage (ABN) to a Medicare beneficiary, how to complete the ABN form correctly and provide answers to many of the questions providers of therapy services have regarding the ABN.

Read More
07/05/21

Advance Beneficiary Notice of Non-coverage Modifiers

In this article, I will explain the 4 sets of modifiers that could be applicable to the advance beneficiary notice of non-coverage (ABN) form that is used for traditional Medicare beneficiaries. QuestionWhat are the advance beneficiary notice of non-coverage modifiers? Answer QuestionWhat is the description of each of the modifiers? Answer QuestionWhen would I use each of the modifiers? Answer QuestionDoes the Centers for Medicare and Medicaid have any resources regarding the ABN? Answer I hope you found this article informative and that you now have a better understanding of the modifiers associated with the ABN form. In addition, be

Read More
08/03/20

Renewed ABN Form Mandatory January 2021

This article was updated on August 3, 2020 as CMS did change the effective date. Per the Centers for Medicare and Medicaid Services, the Advance Beneficiary Notice of Noncoverage (ABN), Form CMS-R-131, and form instructions have been approved by the Office of Management and Budget (OMB) for renewal. The use of the renewed form with the expiration date of 06/30/2023 will be mandatory on I hope you found this article helpful. Thank you for being a Gold Member!

Read More
11/04/19

Will CMS Pay for Dry Needling in 2020

On January 1, 2020, there will be 2 new CPT codes to report needle insertion(s) (i.e. dry needling) for qualified healthcare professionals, such as physical therapists, who provide dry needling where allowed by state law and state practice act. Now, just because we have the new CPT codes that describe dry needling does not mean the Medicare program and other insurance carriers have to pay for them. In this article, I will provide the 2 new CPT codes and also tell you if the Medicare program is going to pay for the codes. The 2 new CPT codes that describe

Read More
06/03/19

Distinguishing Between the GA, GX, GY and GZ Modifiers

There are many modifiers providers of therapy services are use to adding to CPT codes on the claim forms. Common modifiers include the KX modifier, 59-modifier and therapy specific modifiers of GN, GO and GP. But do you know the following modifiers and when to use them: GA, GX, GY and GZ? In this article, I will discuss when to use these modifiers on a CPT code on the claim form for therapy services. In addition, if you have additional questions on when to issue an advance beneficiary notice of non-coverage (ABN) form to a Medicare beneficiary, check out my

Read More
01/21/19

Skilled Nursing Facility ABN

The Centers for Medicare and Medicaid Services (CMS) has released an updated transmittal providing instructions when a skilled nursing facility (SNF) should and should not issue an advance beneficiary notice of non-coverage (ABN) to a Medicare beneficiary. To read the SNF ABN instructions of when to and when not to issue a SNF ABN, ABN specific delivery issues, special rules for SNF ABN’s, establishing when beneficiary Is on notice of non-coverage, and sources of beneficiary notification, click

Read More