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Thread: Guidelines for SB modifier

  1. #1
    Join Date
    Apr 2007
    Columbus, Ohio

    Question Guidelines for SB modifier

    AAPC: Back to School
    Hello coders, I need your help. I normally bill ortho charges but have been given an outpatient OB/GYN group that uses certified nurse midwives. Are there any guidelines about which insurances require the SB modifier? Is it used across the board for all insurances? Is it used on E/M and procedure codes alike? Can you suggest any coding resources besides the medicare website? Thanks for all your help, Paula

  2. #2
    Join Date
    Apr 2007
    Gainesville, GA

    Default Sb modifier

    Most 3rd party payers to not require you to use SB modifiers. I've done billing for OB/GYN's for over 13 years and have never used it. (Not even for medicare. You do need to use -QA for them if the patient did sign her ABN.) Make sure they are credentialed under the plan before billing alone and not needed to be billed under provider as supervising MD. Most contracts or payer websites for the carrier will have billing manuals that specify how to bill for mid-level providers.

    Your state may have different requirements though. Check the billing manual for your specific payer. That way you have accurate info for each.

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