Premera Blue Cross of Washington prior authorization 43257

Premera Blue Cross of Washington prior authorization for 43257: Esophagogastroduodenoscopy, flexible, transoral; with delivery of thermal energy to the muscle of lower esophageal sphincter and/or gastric cardia, for treatment of gastroesophageal reflux disease

Code: 43257
Description: Esophagogastroduodenoscopy, flexible, transoral; with delivery of thermal energy to the muscle of lower esophageal sphincter and/or gastric cardia, for treatment of gastroesophageal reflux disease
Source: Clinical Review by Code List PBCWA, Pg 338 Original policy

Premera Blue Cross of Washington prior authorization

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