APR 19, 2016
ABN for Oculofacial Procedures
Question: I was told recently that we should obtain an advance beneficiary notice for lesion removals for Medicare Part B patients. Is it also recommended for blepharoplasties, even if they are functional?
Answer: As a safety net for payment, we recommend oculofacial practices obtain an advance beneficiary notice on all procedures that might potentially be deemed cosmetic. For example, if Medicare Part B recoups payment on a blepharoplasty that the surgeon felt was functional, the practice may not be able to collect payment from the patient without the ABN. We also recommend ABNs when you are unsure if either a diagnosis or the frequency of a test is covered.