Medical Coding

Answer: A - An ABN is a written document that must be given to the beneficiary before furnishing items or services that are usually covered by Medicare but that may not be covered in a specific instance, such as lack of medical necessity. It allows the beneficiary to make an informed decision about whether to accept financial responsibility if Medicare doesn’t pay for the service/item furnished.

This document does not guarantee coverage by Medicare, instead it is a means to protect the provider’s office or institute from being financially liable for a service or item that may not be paid for reasons, such as lack of medical necessity. If the beneficiary is not given written notice, they may not be held responsible for any fees not covered by Medicare. Patients do not have to sign this form, but services then do not have to be provided.