Correct Use of the Medicare ABN for Chiropractic

These are all the crazy and incorrect things we’ve heard about how DCs and CAs are taught to use the Medicare ABN form:

• Get it signed on every single visit
• Get it signed on every single visit that there is an adjustment
• Get it signed to explain why Medicare doesn’t cover exams, x-rays, and therapies
• Get it signed on the first visit of every new episode of care

And the story goes on and on.

The actual and correct use of the ABN in Chiropractic gets muddied because there’s confusion about what a “non-covered” service is and what an “excluded” service is. So here’s what you need to know:

The ABN is signed only when the visit that is otherwise covered (spinal CMT, for example) will likely not be covered today. 99.9% of the time, that means maintenance care. Once an ABN is signed for the CMT that is likely not covered, if the patient remains in maintenance care, it’s good for up to a year. If they begin a new episode of care for which you’re billing Medicare, then that ABN is null and void. The patient has a course of active treatment, and then, when they move back to maintenance care again, a new episode of maintenance begins. A new ABN is therefore necessary. And that, too, would be good for up to one year, or until the patient goes back into active treatment again.

We’ve got easy-to-follow, budget-friendly training on ABN use, including sample forms, the way they are to be filled out. Find out more here.