How do I determine if an Advance Beneficiary Notice (ABN) is required for a screening, such as mammography or Prostate-Specific Antigen (PSA)?
You can verify prior screening information on page 6 of Health Insurance Query Access (HIQA). For any item or service for which Medicare has established a regulatory frequency limitation on coverage, routinely issued ABNs are permitted. The ABN must state that “Medicare does not pay for this item or service more often than [frequency limit]. For additional details, refer to previous question, “Can ABN’s be given on a routine basis ?”.
