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SG Modifier

  1. Default SG Modifier
    Medical Coding Books
    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.


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

  3. Default
    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.

  4. Default
    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.

  5. #5
    Greeley, Colorado
    Does this apply to ALL payers or just Medicare?

  6. Default
    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.

  7. #7
    Salt Lake City
    Question 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?!
    codermcdreamy CPC, CPC-H

  8. #8
    Smile Sg Modifier
    Quote Originally Posted by johnithomas View Post
    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)

  9. Default
    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 ?

  10. Default
    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.

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