Prior Auth Required

43275 - biliary/pancreatic duct(s)

This procedure appears on the selected insurer prior authorization source.

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Prior authorizationPrior Auth Required
Procedure / Servicebiliary/pancreatic duct(s)
Procedure / Service Description

Code NAME/DESCRIPTION COMMENTS - 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) Endoscopic retrograde cholangiopancreatography (ERCP); with removal and exchange of stent(s), 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.