GA - JE Part A
Waiver of liability statement issued as required by payer. The provider has provided an Advance Beneficiary Notice of Noncoverage (ABN) to the patient.
- Append when ABN provided and denial expected on an item or service as it is not reasonable and necessary
- Append when ABN provided and provider determines services will not be covered based on an active Local Coverage Determination (LCD)
- Append when ABN provided and if Medicare determines that service is not payable, claim denial is under a "medical necessity denial"
- Appending when provider has no expectation that an item or service will be denied
- Appending on a routine basis for all services performed by provider
- CMS Internet Only Manual (IOM), Medicare Claims Process Manual, Publication 100-04, Chapter 1, section 60.4.2
Last Updated Fri, 16 Dec 2022 18:47:21 +0000