Prior Auth Required

43259 - The following services will now be

This procedure appears on the selected insurer prior authorization source.

Prior authorizationPrior Auth Required
Procedure / ServiceThe following services will now be
Procedure / Service Description

Category Subcategory/notes Codes and comments - Esophagogastroduodenoscopy 43235, 43237, 43238, (EGD) 43239, 43242, 43252, 43253, 43259 The following services will now be managed by Cohere Health®.

Likely documents
  • Confirm benefit details
  • Submit clinical notes if requested by the plan
Next actions
  • Confirm the current plan policy before submission.
  • Use the insurer authorization workflow for this listed code.