Observation and ABNs

[terrymatherne]

Yes, they are. According to Noridian:

Q26. Are we required to give the patient an ABN for observation stays over 48 hours?

A26. Providers are required to give beneficiaries an ABN when:

1. Overall medical necessity of a recognized Medicare benefit is in doubt, under §1879 and §1862 (a) (1) of the Act, or
2. Care that was previously covered is to be reduced or terminated, usually because medical necessity for the service is doubted by the provider.

Therefore, if a patient remains in the facility for an observation stay longer than is medically necessary, an ABN would be required whether or not the stay is over 48 hours.