Revised Medicare ABN Form Is Now Ready for Physicians to Download

CMS is notifying health care providers and suppliers that it has updated its Advance Beneficiary Notice of Noncoverage, or ABN, form and made the revised form and information on how to use it available online.

Use of the revised ABN, which is issued to patients by physicians and other health care professionals, laboratories and suppliers "in situations where Medicare payment is expected to be denied," will become mandatory on Nov. 1, 2011. At that time, the 2008 form will be considered invalid, said CMS.

Because using the appropriate form is critical to physicians getting paid, Cynthia Hughes, C.P.C., an AAFP coding and compliance specialist, advised physicians to start using the revised form before the deadline kicks in.

"If physicians have a batch of the old forms already printed, they have time to use them up before switching to the new form," said Hughes. "But if they don't have the old form preprinted, it makes sense to get in the habit of using the revised ABN now."

It's also worth noting that the formatting changes in the revised ABN are barely noticeable, and physicians could unwittingly use the expired form on or after Nov. 1. Hughes urged physicians to check the lower left hand corner of the document for the words "Form CMS-R-131" and the revised date "03/11" to ensure that they have the revised form in hand.

"Physicians must have a current and properly executed ABN, because if Medicare denies the services, the physician can't go back and collect payment from the patient," she said.

For members' convenience, the Academy has posted on its website downloadable copies of the new form in English (1-page PDF; About PDFs) and in Spanish (1-page PDF; About PDFs).

To learn more, members can read a blog entry about the new ABN form that Hughes posted on July 6 to Family Practice Management's "Getting Paid" blog.