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September 1, 2008 all providers and suppliers must begin using the newly revised ABN form called CMS-R-131.
On March 3, 2008 CMS announced the implementation of the revised ABN form. During the last 6 month transition period both the revised and the two earlier CMS versions were accepted.
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| Medicare ABN Compliance |
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The revised ABN form combined both the General Use ABN (CMS-R-131-G), and the Lab ABN (CMS-R-131-L) for the physician ordered laboratory tests. Important-The revised ABN eliminates any widespread need for the Notice of Exclusion from Medicare Benefits (NEMB) used in voluntary notification situations.
An ABN is to be provided to Medicare patients PRIOR to clinical care. Only those Medicare services performed in an outpatient setting require validation of medical necessity. An ABN is never required in an emergency or urgent care situation. It is the obligation of every provider to inform Medicare patients if services do not meet medical necessity. Medical necessity is predicated on Medicare local and national coverage polices which change monthly and/or quarterly.
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