SG Modifier

hnybunny

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I just read in the AAPC newsletter that effective 1/1/08, ASCs are no longer supposed to bill with the SG modifier and instead bill with TOS code F.

Does anyone know if this rule has really been implemented by CMS? The newsletter is the only place that I have heard of this.

Thanks.
 

debboyer

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yes the sg modifier is no longer to be used, look on the fasa web site for more info also.
 

hnybunny

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Thanks for the response. Yes, I have tried to find this on the FASA website but haven't found it yet. I'm not very thrilled with the new format of the FASA website either. It's not anywhere near as user friendly as it used to be. :eek:
 

johnithomas

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Go to the web site click on Medicare Tab (drop down box click on ASC payment system, then you click on, Click Here for Med Learn Article its on page 10 section 50....I dont understand it..let me know your thoughts.
 

johnithomas

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I believe its just Medicare, but I dont understand it. Can you still use the SG modifier, if so why do we need the other? I have not been able to find out why or what the change is for.
 

Deadpd

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SG

Medicare makes the rules for them. As of now, the SG only applies to Medicare, but I'm sure as time goes by, the commercial ins companies will follow suit. Just keep an eye out.

Gotta love the new status indicator codes eh?!
 

KScoderTN

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Wichita, KS
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Sg Modifier

I believe its just Medicare, but I dont understand it. Can you still use the SG modifier, if so why do we need the other? I have not been able to find out why or what the change is for.
I attended a Kansas Medicare workshop yesterday and asked this same question. Our rep told us we could still use the SG, their system won't reject it, it just doesn't require it any longer. I emailed KS BCBS and that rep told me they still require the SG modifier. Our office has opted to continue the use, it just keeps things more streamlined. (for now anyways)
 

johnithomas

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Great news, thanks! I think thats what we will do as well. So then last question, for Medicare are you required to use the TOS - F ?
 

hnybunny

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I'm still waiting to see if Medicare pays or denies our claims for 2008. We haven't changed anything in our system yet. I just called the dreaded Medicare automated system and our claims for 01/02/08 are still pending. I'm hoping they just get paid and then we will just leave things alone for now. What a pain.
 

bbates

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Sg Modifier Answer

Medicare will pay with or without the SG Modifier until May 23, 2008. Somebody told me if the SG Modifier is on the claim after May 23, 2003 the claim could get rejected. Other payers that we file the 1500 form on have asked us to leave the SG modifier on the claim. I myself have not heard of or am I using another Modifier in it's place. Our claims from Medicare are still getting paid.
 
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