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The page below is a sample from the LabCE course Medicare Compliance for Clinical Laboratories. Access the complete course and earn ASCLS P.A.C.E.-approved continuing education credits by subscribing online.

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Advance Beneficiary Notices (ABNs) and the Billing Department

A laboratory may not bill a Medicare beneficiary for a test unless it notifies the patient in writing before the testing is done that Medicare is not going to pay for the test. This notice is called an ABN.

  • The ABN must contain the specific name of the test and give a specific reason the laboratory thinks payment for the test will be denied.
  • The beneficiary should sign the ABN and a copy should be sent to the laboratory and one given to the beneficiary.

The billing department must have evidence that the ABN has been signed before it bills a patient. A laboratory may bill Medicare even though it knows it will not be paid when it has evidence an ABN has been signed.