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30.2.35 Surgery
Surgical services, including surgical procedures involving an assistant surgeon or cosurgeon, are a benefit of the CSHCN Services Program.
Authorization of cosurgeon and assistant surgeon services is not required; however, all other authorization requirements associated with the surgical procedure must be met.
Specific surgical procedures require prior authorization. If a prior authorization is not obtained for the procedure, the facility's services, the surgeon's services and the assistant surgeon's services are denied; however, anesthesia services may be paid.
Prior authorization must be obtained for procedures that are completed by a specialty team or in a specialty center. Criteria unique to specific surgical procedures must be satisfied as indicated in the appropriate sections below.
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