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Thread: Modifier SG

  1. #1

    Default Modifier SG

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    Until 12/31/2007, modifier SG was used for ASC facility billing. Since 01/01/2008, Medicare did away with the modifier SG. Is there any modifier which replaced the modifier SG or claims will simply go out without any modifier?

    Thanks!

  2. #2
    Join Date
    Apr 2007
    Location
    Charlotte, NC
    Posts
    534

    Default

    You still use the SG modifier with all payors except Medicare (unless otherwise stated in your contract).

    Of course, if you are billing on a UB04 you shouldn't need the SG mod. But you still might use it jsut in case.

  3. #3

    Default

    Quote Originally Posted by Partha View Post
    Until 12/31/2007, modifier SG was used for ASC facility billing. Since 01/01/2008, Medicare did away with the modifier SG. Is there any modifier which replaced the modifier SG or claims will simply go out without any modifier?

    Thanks!
    For ASC claims going to Medicare you don't need to attach any modifier to indicate ASC facility any longer. They can tell the difference between your Surgeon's bill and the ASC bill by who the claim is from in Box 31 on the CMS 1500.

    Jenna
    Last edited by JMeggett; 04-27-2010 at 10:03 AM.

  4. #4

    Default

    I recently found out that as of 3/24/2010 Tricare no longer wants the SG modifier either. Is anyone else aware of this?

  5. #5

    Default

    Quote Originally Posted by jenjo View Post
    I recently found out that as of 3/24/2010 Tricare no longer wants the SG modifier either. Is anyone else aware of this?
    Tricare is also a government run insurance...so that doesn't surprise me that they're following Medicare's lead on this. Tricare refuses to process our ASC claims as of 04/01/09, saying we must submit them on a UB04 claim. We're not hospital! We bill on CMS1500's! But there's no reasoning with them.

    Jenna

  6. #6
    Join Date
    Apr 2007
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    Stuart
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    I don't use the SG modifier in any of my claims and I get pay with no problem; including commercial claims.
    NoRaX

  7. #7
    Join Date
    Apr 2007
    Location
    Charlotte, NC
    Posts
    534

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    JMeggett,

    UB04 is not just for hospitals. It is for facilities. Hence the Endoscopy ASC's I work for use UB04's.

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