US · guidance
CMS Pub. 100-04, ch. 18, § 110.3.3
Advance Beneficiary Notice
A/B MACs (A) and (B) will deny an AAA screening service billed more than once in a beneficiary’s lifetime.
If a second AAA ultrasound screening is billed for the same beneficiary or if any of the other statutory criteria for
coverage listed in section 1861(s)(2)(AA) of the Social Security Act are not met, the service would be denied as a
statutory (technical) denial under section 1861(s)(2)(AA), not a medical necessity denial.
If a provider cannot determine whether or not the beneficiary has previously had an AAA screening, but all of the
other statutory requirements for coverage have been met, the provider should issue the ABN-G. Likewise, if all of the
statutory requirements for coverage have been met, but a question of medical necessity still exists, the provider should
issue the ABN-G.
History
(Rev. 3669, Issued: 12-02-16, Effective: 01-01-17, Implementation: 01-03-17)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
152ec95bfa43653e411d3ffd6974f4bccf8cc2cd00fe012ce9ff4b16e8e2a8ff
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