Option 2 on the Medicare ABN
Any time that you reasonably expect that Medicare will not pay for the adjustment, you should have the patient sign an Advance Beneficiary Notice or ABN.
Option 2 on the ABN form only applies to non-covered services. Since the only covered service for chiropractic is the adjustment, this is the only service that is generally listed on the ABN.
You are not required to list non-covered services such as exams, x-rays and therapies on the ABN. However, if you wish to have the patient sign an ABN for non-covered services, you may do so.
Option 2 cannot be used as a way of getting around the requirement to file the adjustments for the patient. All adjustments must be filed. This includes maintenance adjustments which are not payable but are still considered to be covered services. The requirement to file the adjustment must still be met even if the patient pays for their services and requests that you to not file their Medicare claims.
Complete instructions on the ABN as well as how to properly modify services filed to Medicare are covered in our Medicare Course