Prior Auth Required

43264 - biliary/pancreatic duct(s)

This procedure appears on the selected insurer prior authorization source.

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Procedure / Servicebiliary/pancreatic duct(s)
Procedure / Service Description

Code NAME/DESCRIPTION COMMENTS - 43262 Endoscopic retrograde cholangiopancreatography (ERCP); with sphincterotomy/papillotomy Endoscopic retrograde cholangiopancreatography (ERCP); with removal of calculi/debris from 43264 biliary/pancreatic duct(s) Endoscopic retrograde cholangiopancreatography (ERCP); with placement of endoscopic stent into biliary or pancreatic duct, including pre- and post-dilation and guide wire passage, when performed, including

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.