Update: CPAPs, blanket ABNs

Friday, July 31, 2009

BALTIMORE--The DME MACs provided additional information on using advanced beneficiary notices (ABNs) for CPAPs in June when it published a revised question and answer. The question: Would it be considered use of a blanket ABN to have all new PAP patients sign an ABN at the beginning of therapy stating that if they do not get a face-to-face evaluation or refuse to get the follow-up re-examination by their treating physician between the 31st and 91st day that Medicare will deny the claim? The answer: Yes, it would be considered a “blanket” ABN if the notice was presented at the beginning of therapy. After day 60, following the dispensing of the PAP device, the supplier may, however, present an ABN to the beneficiary if the supplier has knowledge that the beneficiary has not yet met the policy criteria for continued coverage. The new guidance is effective for claims with initial dates of service on or after July 1, 2009.