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Ohio Part B Carrier
Advance Beneficiary Notice of Noncoverage (ABN) Form

The Centers for Medicare & Medicaid Services (CMS) implemented use of the revised Advance Beneficiary Notice of Noncoverage (ABN), which combines the general Advance Beneficiary Notice (ABN-G) and laboratory Advance Beneficiary Notice (ABN-L) into a single form with form number (CMS R-131). The revised form also incorporates the Notice of Exclusion from Medicare Benefits (NEMB) form.

Effective March 1, 2009, the only acceptable form for ABNs is the revised ABN (CMS R-131).

Please make sure that your billing staff is aware of these ABN form changes.

More information about the revised Advance Beneficiary Notice of Noncoverage (ABN) is available in the CMS MLN Matters article MM 6136 (PDF, 81 KB).

If you have questions, please contact our Provider Contact Center at the appropriate toll-free number:

  • Ohio and West Virginia: (866) 332-7025
  • South Carolina Part B: (888) 828-2092

 

last updated on 05/28/2009
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