Medicare Claims Processing Manual (Pub. 100-04), Ch. 14 § 50

ASC Procedures for Completing the ASC X12 837 Professional

Last amended: 2023Year: 2023Length: 115 wordsOfficial source
50 - ASC Procedures for Completing the ASC X12 837 Professional Claim Format or the Form CMS-1500 (Rev.11793; Issued:01-19-23; Effective: 02-21-23; Implementation: 02-21-23) The Place of Service (POS) code is 24 for procedures performed in an ASC. Prior to January 1, 2008, Type of Service (TOS) code is “F” (ASC Facility Usage for Surgical Services) is appropriate when modifier SG appears on an ASC claim. Otherwise TOS “2” (surgery) for professional services rendered in an ASC is appropriate. Beginning January 1, 2008, ASCs no longer are required to include the SG modifier on facility claims in Medicare. The contractors shall assign TOS code “F” to codes billed by specialty 49 for Place of Service 24.
Medicare Claims Processing Manual (Pub. 100-04), Ch. 14 § 50: ASC Procedures for Completing the ASC X12 837 Professional | Justis AI