Final answer:
The Local Coverage Determination (LCD) is the form that defines the codes needed and the coverage parameters for a Medicare item or service, based on the criteria of being reasonable and necessary.
Step-by-step explanation:
The form that further defines what codes are needed and when an item or service will be covered is the Local Coverage Determination (LCD). An LCD is a decision by a Medicare Administrative Contractor (MAC) that states when and under what circumstances an item or service is covered by Medicare.
These decisions are based on Section 1862(a)(1)(A) of the Social Security Act which allows coverage and payment for only those services that are considered to be reasonable and necessary.
The other options listed, such as the UB-04 and CMS-1500, are types of insurance claim forms and the Advance Beneficiary Notice (ABN) is a notice given to beneficiaries in original Medicare to convey that Medicare is not likely to provide coverage in a specific case.
The form that further defines what codes are needed and when an item or service will be covered is the Local Coverage Determination (LCD). LCDs are issued by Medicare Administrative Contractors (MACs) and provide guidance on medical necessity and coverage criteria for specific services or items within a particular geographic area.