CG-SURG-10 Ambulatory or Outpatient Surgery Center Procedures

Policy CG-SURG-10 addresses when procedures should be performed in an ambulatory/outpatient surgery center (ASC) instead of an office-based setting. ASC use is medically necessary when the procedure is too complex for an office but does not require hospital-level resources—such as needing anesthesia/sedation beyond topical/digital block/local with physiologic monitoring, or a recovery period longer than an office can safely manage; all other ASC use in place of an office is not medically necessary. Minor procedures (e.g., simple skin or nail procedures, minor aspirations/injections, simple wound repair, superficial foreign body removal) generally do not warrant ASC use.

"The use of an outpatient or ambulatory surgery center (ASC) facility, rather than an office-based setting, is consideredmedically necessarywhenanyof the following criteria are met:"

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