# Modifier SG



## Partha

*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!*


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## coachlang3

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.


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## JMeggett

Partha said:


> *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


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## jenjo

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


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## JMeggett

jenjo said:


> 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


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## elenax

I don't use the SG modifier in any of my claims and I get pay with no problem; including commercial claims.


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## coachlang3

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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