# New to ASC Billing



## LORA CRAWFORD (Mar 25, 2008)

I am new to ASC billing and need a bit of guidance. I am in AZ and have been told that the AHCCCS claims are required to be billed on a UB-04.(?) I also read in a Medicare publication that each procedure gets a modifier of SG. Is that always the first modifier? Any bit of assistance would be helpful. Lora


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## mbort (Mar 25, 2008)

Hi Lisa,

Welcome the the ASC world!!  Claims should be billed on the UB92 (could be called the UB04 now???)  Medicare did away with the SG modifier as of 1-1-08however you may find that some payors will still require it (DOL, Tricare, ect).  I dont know of any commercial payors that require it but could be possible.  That will be trial and error.

Hope this helps.

Good Luck 
Mary


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## elenax (Mar 26, 2008)

I bill most of my claim on *UB-04*; *Medicare, Worker's Comp *and *Auto* I bill on the *cms1500 *but you can also bill these on *UB-04* if you have all the required information.  The Modifier *SG* is *invalid* for *2008;* prior to that year it was required.

hope this helps!


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## mbort (Mar 27, 2008)

Sorry..I also bill my Medicare claims on a CMS 1500, there are a few W/C carriers (DOL) that use the 1500 as well as Tricare.


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## gared111 (Mar 27, 2008)

LORA CRAWFORD said:


> I am new to ASC billing and need a bit of guidance. I am in AZ and have been told that the AHCCCS claims are required to be billed on a UB-04.(?) I also read in a Medicare publication that each procedure gets a modifier of SG. Is that always the first modifier? Any bit of assistance would be helpful. Lora



Medicare dropped the SG modifier for 2008 as already stated but I use it as the first modifier for almost every other payer.  There of course are exceptions to that such as radiology where you would use just a TC modifier (assuming you're just billing the technical component in an ASC...use 26 if your billing for the physician side of it).  As for Tricare I bill that on a UB (with full signature!) & have never been asked to resubmit on a CMS1500 .  Washington state Medicaid doesn't use the SG modifier but if billing for multiple procedures they ask you to use U1 for the first procedure U2 for the 2nd & so on.

Medicare & workers comp still require the CMS1500 for ASC's but I use the UB for most other payers.


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