Prior Auth Required

43289 - Unlisted laparoscopy procedure, Medical necessity review will be Medical Necessity Review required at claims submission

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Procedure / ServiceUnlisted laparoscopy procedure, Medical necessity review will be Medical Necessity Review required at claims submission
Procedure / Service Description

Code Description Plan Review Requirement Reviewed For Records Request - 43285 Removal of esophageal sphincter Possible Denial; Medical Records Investigative Documentation optional. augmentation device Optional 43289 Unlisted laparoscopy procedure, Medical necessity review will be Medical Necessity Review required at claims submission; esophagus performed upon claims submission submit description of procedure with with supporting documentation. supporting documentation (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.