Medical Billing Forum
Payments => Insurance Payments => : sequelian July 15, 2011, 03:30:36 AM
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Hi all,
Can anybody confirm that why Medicare does not pay CPT 13131 if billed with modifier SG and the POS type as Ambulatory Surgical Center.
Have a nice day!!!
Tayyab
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-SG — ASC facility service (A)
For dates of service through Dec. 31, 2007, ASCs needed to use the -SG modifier on each CPT code billed on claims filed to Medicare. The changes to the Medicare program for ASCs now has Medicare requiring that, for dates of service starting Jan. 1, 2008, that ASCs are not to use the -SG modifier. This modifier may still be required by some payors on claims filed on CMS-1500 claim forms (such as Medicaid claims, if required). You should continue using –SG for payors who have previously required its use until they direct you to do otherwise. It is not necessary to use the -SG modifier on codes listed on claims filed on UB-04 claim forms going to other payors unless the payor requires its use. Do not use the –SG modifier on HCPCS codes billed for implants for radiology codes unless otherwise directed by the payor.
From: http://www.beckersasc.com/asc-coding-billing-and-collections/coders-guide-to-asc-and-physician-practice-modifiers.html