Prior Auth Required

43274 - sphincterotomy, when performed, each stent

This procedure appears on the selected insurer prior authorization source.

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Procedure / Servicesphincterotomy, when performed, each stent
Procedure / Service Description

Code NAME/DESCRIPTION COMMENTS - 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 43274 sphincterotomy, when performed, each stent Endoscopic retrograde cholangiopancreatography (ERCP); with removal of foreign body(s) or stent(s) from 43275 biliary/pancreatic duct(s)

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.