Gastroenterology Coding Alert

Question: I heard at a Medicare webinar that as of Jan. 1, we would no longer need to use modifier SG to reflect facility charges. Anyone else hear this? Is this only for Medicare claims or for commercial insurers also?

Virginia Subscriber

Answer: Beginning Jan. 1, 2008, ambulatory surgery centers (ASCs) no longer need to include modifier SG (ASC facility service) on facility claims in Medicare.

In the past: Prior to Jan. 1, you used type of service code "F" (ASC facility usage for surgical services) when modifier SG appears on an ASC claim. You will still use the TOS code "F" for the ASC charges for 2008. Otherwise, you should report TOS "2" (Surgery) for professional services rendered in an ASC. The TOS code 2 is for the professional claim only.