43774 prior authorization | Blue Cross Blue Shield Oklahoma

43774, Laparoscopy, surgical, gastric restrictive procedure; removal of adjustable gastric restrictive device and subcutaneous port components, is on the Blue Cross Blue Shield Oklahoma commercial prior authorization list. Not a coverage or referral decision.

Code: 43774
Description: Laparoscopy, surgical, gastric restrictive procedure; removal of adjustable gastric restrictive device and subcutaneous port components
Source: 2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 236 Original policy

Blue Cross Blue Shield Oklahoma prior authorization

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