43773 prior authorization | Blue Cross and Blue Shield of Montana

43773, Laparoscopy, surgical, gastric restrictive procedure; removal and replacement of adjustable gastric restrictive device component only, is on the Blue Cross and Blue Shield of Montana commercial prior authorization list. Not a coverage or referral decision.

Code: 43773
Description: Laparoscopy, surgical, gastric restrictive procedure; removal and replacement of adjustable gastric restrictive device component only
Source: 2026 Commercial Medical Surgical Prior Authorization Code List, Pg 43 Original policy

Blue Cross and Blue Shield of Montana prior authorization

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