43644 prior authorization | Blue Cross Blue Shield Oklahoma

43644, Laparoscopy, surgical, gastric restrictive procedure; with gastric bypass and Roux-en-Y gastroenterostomy (roux limb 150 cm or less), is on the Blue Cross Blue Shield Oklahoma commercial 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: 2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 235 Original policy

Blue Cross Blue Shield Oklahoma prior authorization

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