Description of ASC Facility Services

ASC facility services include all services and supplies required for the surgery and the procedures performed in connection with a covered surgical procedure performed in an ASC with the exception of items reimbursed pursuant to the specifications outlined for Surgical Implants, Associated Disposable Instrumentation and shipping and handling in this Manual.

ASC facility services include, but are not limited to, the following:

• Nursing and technical personnel services and other related services;

• Use of the operating and recovery rooms, patient preparation areas, waiting room, and other areas used by the patient or offered for use by the patient’s relatives, attendants or companions, or other person(s) accompanying the injured worker in connection with surgical services;

• Drugs, biologicals, intravenous fluids and tubing, surgical dressings, splints, casts, surgical supplies and equipment (required for both the patient and the ASC personnel, e.g., fiberoptic scopes and the associated supplies, gowns, masks, drapes, case pack and their contents, operating and recovery room equipment) commonly furnished by the ASC in connection with the surgical procedure;

• Diagnostic or therapeutic items and services: many ASCs perform simple test(s) just before surgery, such as urinalysis, blood hemoglobin or hematocrit, or blood glucose which are included in the ASC facility charges and are considered to be facility services;

• Administrative, recordkeeping, and housekeeping items (i.e., administrative functions necessary to run the facility, such as scheduling, cleaning, linens, and utilities, leases or rent);

• Mortgage, lease or rent payment(s) on the facility itself; lease or rent payments on any equipment within the ASC,

• Blood, blood plasma or platelets: ASC procedures are limited to those not expected to result in extensive blood loss, but in some cases, blood or blood products are required; and

• Materials for anesthesia including the anesthesia itself, and any materials, whether disposable or reusable, necessary for its administration.