0253T prior authorization | Blue Cross and Blue Shield of Montana

0253T, Insertion of anterior segment aqueous drainage device, without extraocular reservoir, internal approach, into the suprachoroidal space, is on the Blue Cross and Blue Shield of Montana commercial prior authorization list. Not a coverage or referral decision.

Code: 0253T
Description: Insertion of anterior segment aqueous drainage device, without extraocular reservoir, internal approach, into the suprachoroidal space
Source: 2026 Commercial Medical Surgical Prior Authorization Code List, Pg 194 Original policy

Blue Cross and Blue Shield of Montana prior authorization

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