43644 prior authorization | Anthem Blue Cross and Blue Shield New Hampshire

43644, Laparoscopy, surgical, gastric restrictive procedure; with gastric bypass and Roux- en-Y gastroenterostomy (roux limb 150 cm or less), is on the Anthem Blue Cross and Blue Shield New Hampshire prior authorization list. Not a coverage or referral decision.

Code: 43644
Description: Laparoscopy, surgical, gastric restrictive procedure; with gastric bypass and Roux- en-Y gastroenterostomy (roux limb 150 cm or less)
Source: New Hampshire Precertification List, Pg 118 Original policy

Anthem Blue Cross and Blue Shield New Hampshire prior authorization

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