43889 prior authorization | Blue Cross and Blue Shield of Montana

43889, Gastric restrictive procedure, transoral, endoscopic sleeve gastroplasty (ESG), including argon plasma coagulation, when performed, is on the Blue Cross and Blue Shield of Montana commercial prior authorization list. Not a coverage or referral decision.

Code: 43889
Description: Gastric restrictive procedure, transoral, endoscopic sleeve gastroplasty (ESG), including argon plasma coagulation, when performed
Source: 2026 Commercial Medical Surgical Prior Authorization Code List, Pg 45 Original policy

Blue Cross and Blue Shield of Montana prior authorization

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