Medicare ABN rules

I have been on Medicare for a good number of years but last year was my first encounter with an “Advance Beneficiary Notice of Non-coverage” (ABN). I have had two other ABNs so far this year. ABNs are explained in the Medicare Billing Manual but the providers who hand me an ABN do not seem to follow the requirements of the Manual.

For example, my understanding is that the Manual requires all questions about the ABN to be answered. I was given an ABN by a laboratory technician recently who said it was not her responsibility to answer questions and refused. A Medicare representative told me that the a lab would only have limited information that would allow answering questions which is not in line with the Manual.

Do you know where I could find information on how ABNs are generated, what are the real rules, and who enforces the rules. I have read much on the Internet and most of the information is for providers and not patients. I do not understand medical coding. Talking with Medicare representatives has not helped. My doctor stated that he did not understand how Medicare works.