Wiki SG Modifier Per Coding Edge Feb. 2008

[bella2]

I was just reading the Feb. edition of the Coding Edge, which said to use the SG modifier forbilling Medicare in an ASC. I thought that as of 2008 we weren't supposed to use the SG modifier for Medicare, and other insurance companies. I'm hoping someone has a clear cut answer for this one !!!
Thanks a bunch,
Sandra

 

[cconroycpch]

As of 1/1/2008, per CMS guidelines, you are not to bill with the SG modifier for Medicare patients. Most other insurance companies do not want the SG modifier either. There are some Medicaid and Tricare areas that still require the use of the SG modifier. So the bottom line is, for Medicare - no SG modifier. For every other insurance company - need to check with them directly. So much for a uniform bill and billing guidelines.

 

[mmendoza]

I would love to get a link or reference for this info. I was unaware of this.

Thanks

 

[codegirl0422]

http://www.cms.hhs.gov/center/asc.asp
~this is the link for info on ASC, if you go on CMS website, select Medicare and then scroll down, you will see ASC, if you select it, it takes you to the above link. I like it because you can view updated/new transmittals related to just ASC.

Link you were requesting:
http://www.cms.hhs.gov/manuals/downloads/clm104c14.pdf
page 26

I would love to get a link or reference for this info. I was unaware of this.

Thanks