Wiki ASC Billing Help

[Danielle]

When you bill out for services that were provided in a ASC I have been told that you bill out the same CPT code twice and append modifier SG on one of the codes. I am not able to locate this information on-line is this correct?
Thanks,
Danielle

 

[Siva03]

Prior to January 1, 2008, type of Service (TOS) code is ?F? (ASC Facility Usage for Surgical Services) is appropriate when modifier SG appears on an ASC claim. Otherwise TOS ?2? (surgery) for professional services rendered in an ASC is appropriate. Beginning January 1, 2008, ASCs no longer are required to include the SG modifier on facility claims in Medicare. The contractors shall assign TOS code ?F? to codes billed by specialty 49 for Place of Service 24.

For further info please refer:Refer to the Centers for Medicare & Medicaid Services (CMS) Internet Only Manuals (IOM) Publication 100-04 cChapter 14 Ambulatory Surgical Centers (ASCs) for more specific information relating to ASC services.

Thanks,
M.Sivakumar, BPT,CPC,CPC-H

 

[Danielle]

Thank you for your help. TO clarify, I would use POS of service 24 for example on CPT code 14060 and only bill this code once with no modifier SG?

 

[l1ttle_0ne]

Medicare doesn't require the SG. But we bill with the SG on all other payers.