Medicare Claims Processing Manual (Pub. 100-04), Ch. 32 § 20.4
Advance Beneficiary Notice (ABN) Information
20.4 - Advance Beneficiary Notice (ABN) Information
(Rev. 1876; Issued: 12-18-09; Effective Date: 01-01-10; Implementation Date: 04-05-10)
If a signed ABN was provided, contractors shall use Group Code PR (Patient Responsibility) and the liability falls to
the beneficiary.
If an ABN was not provided, contractors shall use Group Code CO (Contractual Obligation) and the liability falls to
the provider.