Prior Auth Required

43239 - Esophagogastroduodenoscopy, flexible, Prior Authorization Required Medical Necessity Submit History and Physical, procedure

This procedure appears on the selected insurer prior authorization source.

Prior authorizationPrior Auth Required
Procedure / ServiceEsophagogastroduodenoscopy, flexible, Prior Authorization Required Medical Necessity Submit History and Physical, procedure
Procedure / Service Description

transoral; with directed submucosal documentation of medical necessity and - aspiration/biopsy(s), 43239 Esophagogastroduodenoscopy, flexible, Prior Authorization Required Medical Necessity Submit History and Physical, procedure transoral; with biopsy, single or multiple report. No review needed for member age 18 and under.

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.