As CMS issues its quarterly ASC payment rates, the time to brush up is here. True or false: Modifier SG is required for all ambulatory surgical center (ASC) claims. The answer is false for claims with dates of service after Jan. 1, 2008--and if you got that one right, you're on your way to ASC reimbursement bliss. In a few weeks, CMS will issue its latest quarterly update to the ASC Payment System, which includes HCPCS codes, modifiers, drugs and supplies that are payable for ASCs effective April 1. With so many changes affecting ASCs every year, it's enough to make your head spin -- but despite all of the changes, some aspects of ASC reimbursement have remained the same. We've got the lowdown on how the ASC rules affect you. 1. Know where to find ASC-allowed services. Resource: 2. Remember the 'same-day global' rule. For instance, if a patient experiences postoperative bleeding and the physician must return the patient to the ASC for control of bleeding on the same day, both the physician's coder and the ASC's coder should report the appropriate control-ofbleeding code appended with modifier 78 (Unplanned return to the operating/procedure room by the same physician or other qualified healthcare professional following initial procedure for a related procedure during the postoperative period) because the procedure occurred within the "same-day" global period for the ASC. If, however, the physician returned the patient to the ASC the day after the initial surgery, the ASC coder would report the appropriate control-of-bleeding code with no modifier. For the ASC's purposes, the initial surgery's global period has expired, even though the surgery includes a 90-day global period for physician services. On the other hand, the surgeon's coder would report the bleeding-control code with modifier 78 appended because the physician's services follow the standard global rule. Takeaway: 3. You can skip modifier SG. For dates of service prior to Jan. 1, 2008, ASC coders were required to list the SG modifier first on the claim -- without it, the claim would reject immediately. 4. Discontinued surgery modifiers may differ. "In the event that the physician must stop the procedure due to a medical complication or finding, the ASC will still collect a portion of their reimbursement if billed with modifier 73," says Deb Bridges, CPC-H, coder with University Suburban Health Center in Ohio. "When the physician returns to the ASC with the patient to perform the aborted procedure at a later date or time, the ASC will receive full reimbursement for the completed procedure," Bridges adds. Alternative: 5. Keep in contact with the surgeon's coder.