The following are claim modifiers associated with advance beneficiary notice of noncoverage (ABN) use. For specific instructions on filing claims associated with ABNs, see the Centers for Medicare & Medicaid Services (CMS) Internet-Only Manual (IOM), Publication 100-04, Chapter 1, Section 60.
Use this modifier to report that an advance written notice was provided to the beneficiary of the likelihood of denial of service as being not reasonable and necessary under Medicare guidelines.
Use this modifier to report when you issue a voluntary ABN for a service that Medicare never covers because it is statutorily excluded or is not a Medicare benefit.
Use this modifier to report that Medicare statutorily excludes the item or service or the item or service does not meet the definition of any Medicare benefit.
Use this modifier to report when you expect Medicare to deny payment of the item or service due to a lack of medical necessity and no ABN was issued.