Advance Beneficiary Notice of Noncoverage (ABN)

An ABN may be issued to the beneficiary for every service rendered.

• True

• False

By obtaining a beneficiary signature on the ABN, the provider becomes financially liable for the service.

• True

• False

An ABN may be issued for services not considered reasonable and necessary?

• True

• False

In what instance must you issue an ABN? Select the best answer.

• Experimental and investigational or considered “research only”

• Not indicated for diagnosis and/or treatment in this case

• More than the number of services Medicare allows in a specific period for the corresponding diagnosis

• All of these

A modifier must be appended to your CPT/HCPCS procedure code when an ABN is issued and signed.

• True

• False

When an item or service is not considered reasonable and necessary under Medicare program standards which modifier needs to be appended?

• GX

• GA

• GY

• GZ

Which modifier is used for statutorily excluded items from Medicare coverage?

• GZ

• GX

• GA

• GY

If the provider does not deliver a valid ABN to the beneficiary when required, the beneficiary cannot be billed for the service and the provider may be held financially liable.

• True

• False

When a statutorily excluded service is rendered an ABN needs to issued and signed by the beneficiary?

• True

• False

A beneficiary cannot refuse to choose an option or sign the ABN?

• True

• False