How do I bill for tests which I believe will be denied because the patient’s diagnosis is not covered under either national or local coverage policy?
When an NCD or LCD applies, and the appropriate diagnosis code is not listed as a covered code, a signed Advance Beneficiary Notice (ABN) should be obtained from the patient prior to performing the test. The ABN informs that patient that if the test is denied they are responsible for payment. A properly signed ABN which lists the specific test or service you believe may be denied as well as the reason for probable denial must be obtained in order to bill the patient for a service that is later denied.
Related Questions
- I believe that I have been denied credit at a bank because of my race, color, religion, sex, national origin, age, ancestry, disability, marital status or military status. What should I do?
- If no local coverage policy exists in my state for ionized calcium, what diagnosis codes are appropriate?
- Are contributions to national, state or local political parties covered by the rule?
