CG-SURG-50 Assistant Surgeons

This policy addresses coverage for the use of one assistant surgeon during surgical procedures. It is medically necessary when the American College of Surgeons (ACS) designates the procedure as always requiring an assistant; when ACS designates sometimes and the Centers for Medicare & Medicaid Services (CMS) designates always; or when both ACS and CMS designate sometimes and there is documented clinical need due to procedure complexity or the patient’s condition. It is not medically necessary when ACS designates never; when ACS designates sometimes and CMS designates never; or when a surgical technician could assist without the need for an assistant surgeon’s training; coverage is limited to one assistant surgeon and requires appropriate documentation when indicated.

"Use ofoneassistant surgeon during a surgical procedure may be consideredmedically necessarywhen the following criteria are met:"