As of June 21, 2017, there is a new Advanced Beneficiary Notice of Noncoverage (ABN).
You must use the most recent version of the Advance Beneficiary Notice of Noncoverage (ABN) Form CMS-R-131 with the March 2020 expiration date. If the new form is not used on or after this date, any new ABN executed on the old form will be considered invalid and would result in provider liability if Medicare denies the claim.
Providers may begin using the new ABN Form CMS-R-131 immediately. For more information, please visit the Fee For Service Advance Beneficiary Notice of Noncoverage webpage https://www.cms.gov/Medicare/Medicare-General-Information/BNI/ABN.html
Guidelines for mandatory and voluntary use of the ABN are published in the Internet Only Manual (IOM), Medicare Claims Processing Manual, Chapter 30, Section 50.