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US · guidance

CMS Pub. 100-04, ch. 32, § 170.5

Advance Beneficiary Notice (ABN) and Hospital Issued Notice of Noncoverage

activein force · 2026-08-25 – presentas-observed

(HINN) Information

(Rev. 1340, Issued: 09-21-07, Effective: 08-14-07, Implementation: 10-01-07)

Providers must be advised that the provider is liable for charges if the lumbar artificial disc replacement is

used in the surgery, unless the beneficiary was informed that he/she would be financially responsible prior to

performance of the procedure. To avoid this liability the provider should have the beneficiary sign an ABN.

The HINN model language should be adapted to this situation in the sections addressing description of the

care at issue if the surgery is performed on an inpatient basis. Unless the beneficiary was informed prior to the

admission that he/ she would be financially liable for the admission, the provider is liable. To avoid this

liability the provider must issue a HINN. Other content requirements of a HINN still apply. Use the HINN

letter most appropriate to the overall situation.

History

(Rev. 1340, Issued: 09-21-07, Effective: 08-14-07, Implementation: 10-01-07)

Provenance

Source
cms.gov
Retrieved
2026-08-25
Edition
iom-2026-08-25
Content hash
6b566af00d91d06a119d6603e26b3e646462bcbb1228329569af426d1a943423
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CMS Pub. 100-04, ch. 32, § 170.5 — Advance Beneficiar… · binding.law