It is NOT a blanket ABN. You are doing the right thing.
The typical reasons that Medicare will not cover certain services and that would be applicable are:
1. Statutorily Excluded service/procedure (non-covered service)
2. Frequency Limitations
3. Not Medically Necessary
Statutorily Excluded items are services that Medicare will never cover, such as (not a complete list):
* Complete physicals (excluding Welcome to Medicare Screenings, with caveats)
* Most immunizations (Hepatitis A, Td)
* Personal comfort items
* Cosmetic surgery
For these items, it is a good idea (not a requirement) to complete the ABN and have the patient check the appropriate box under options and sign the ABN. For the sake of the billing department, I strongly encourage the use of ABN’s for statutorily excluded items.
Frequency Limitations are for services that have a specific time frame between services. For example, Medicare allows one pap smear every 24 months if the pap is normal. If the patient wants one every 12 months for their peace of mind, Medicare will pay for year one and the patient will pay for year two and that pattern continues. The ABN needs to be on file for the year that the patient is responsible for paying. If the patient fits Medicare’s guidelines for “high risk” they are allowed to have the pap every 12 months and no ABN is required.