43889 prior authorization | Blue Cross Blue Shield Oklahoma

43889, Gastric restrictive procedure, transoral, endoscopic sleeve gastroplasty (ESG), including argon plasma coagulation, when performed, is on the Blue Cross Blue Shield Oklahoma 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 Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 237 Original policy

Blue Cross Blue Shield Oklahoma prior authorization

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