CMS Manual System

Department of Health & Human Services (DHHS)
Pub 100-08 Medicare Program Integrity
Centers for Medicare & Medicaid Services (CMS)

Transmittal 361
Date: December 10, 2010
Change Request 6988

SUMMARY OF CHANGES: This CR requires that a mandatory ABN (Advanced Beneficiary Notice), shall be requested as part of the ADR on all claims undergoing complex medical record review. Face validity assessment of the ABN shall be done if the claim is determined not to be reasonable and necessary.

EFFECTIVE DATE: January 12, 2011



Complete document is found here. (PDF format, 7 pages, 68 KB)


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