Are You Using the Correct ABN Form?

The Advance Beneficiary Notice of Non-Coverage (ABN) is one of the most misunderstood tools in Medicare billing — and one that can leave practices with denials and takebacks.

An ABN is required when Medicare normally covers a service, but you believe it may not pay in a specific situation. If you fail to issue one properly and Medicare denies the claim, your practice — not the patient — may be financially responsible.

And here’s the compliance question many practices haven’t asked:

The ABN form was updated January 31, 2026. Are you using the correct version?

Using an outdated form can invalidate the notice — and your ability to bill the patient.

In ENT, ABNs are often considered for hearing tests.

Covered (No ABN Required):
When the test is ordered to evaluate or manage a medical condition, such as:

• Sudden hearing loss

• Vertigo/dizziness

• Chronic otitis media

• Asymmetric hearing loss

• Pre- or post-surgical evaluation

Not Covered (ABN Required):
When the test is not for medical treatment, including:

• Hearing aid evaluations

• Annual hearing tests without new complaints

• Patient-requested baseline testing without physician/APP evaluation

The distinction isn’t “Is it a hearing test?”

The real question is:

Is this being ordered to diagnose or manage a medical condition?

If not, an ABN should be issued before the service is provided.

For the full breakdown — including CMS links, updated form access, and specialty-specific guidance — visit the full resource here:

👉 Advance Beneficiary Notice of Non-Coverage (ABN) https://www.brinsongrouphq.com/abn

Make sure your team is using the correct form and issuing it appropriately. Compliance is easier when the rules are clear.