43270 CPT® code: payer coverage and prior authorization7 of 7 payer prior-auth lists that name 43270 require prior authorization or set conditions: Blue Cross Blue Shield of Arizona (AZ Blue), Cigna, Neighborhood Health Partnership, UnitedHealthcare.
| Payer | Plan | State | Prior auth | Conditions | Since | Source |
|---|---|---|---|---|---|---|
| Blue Cross Blue Shield of Arizona (AZ Blue) | Standard PA code list (most commercial plans) | AZ | prior auth under conditions | place of service 19, 21, 22; site of care: hospital (not ASC) | Sep 1, 2026 | AZ Blue Standard Prior Authorization Requirements Code List (09/01/2026) |
| Cigna | ACA/IFP | All | prior auth required | May be delegated to eviCore for some clients | Jan 1, 2022 | Master Precertification List (For Health Care Providers) |
| Cigna | Complete/PHS+/Preferred | All | prior auth required | May be delegated to eviCore for some clients | Jan 1, 2022 | Master Precertification List (For Health Care Providers) |
| Cigna | GI | All | prior auth required | Mar 7, 2026 | Cigna Commercial Comprehensive CPT Code Reference for Prior Authorization Across All Programs | |
| Cigna | GI | All | prior auth required | Mar 7, 2026 | Cigna Commercial Prior Authorization Procedure Code List: Gastroenterology | |
| Neighborhood Health Partnership | Neighborhood Health Partnership | FL | prior auth required | site of care: site of service reviewed | Sep 1, 2026 | Prior authorization requirements for Neighborhood Health Partnership Effective September 1, 2026 |
| UnitedHealthcare | UnitedHealthcare Complete (Individual & Family plans) | All | prior auth under conditions | site of care: outpatient hospital | Sep 1, 2026 | Prior authorization requirements for UnitedHealthcare Complete Effective September 1, 2026 |
43270 appears in 17 coverage policies from Aetna, Anthem, Blue Cross & Blue Shield of Mississippi, Blue Shield of California, BlueCross BlueShield of South Carolina, Capital Blue Cross, Centene, Health Care Service Corporation (BCBS IL, TX, OK, NM, MT).
| Payer | Policy | Role in policy | Reviewed | Document |
|---|---|---|---|---|
| Aetna | Barrett's Esophagus (0728) | covered if criteria are met | Nov 25, 2025 | payer document |
| Aetna | Cryoablation (0100) | covered if criteria are met | Aug 4, 2026 | payer document |
| Aetna | Double Balloon Enteroscopy (0737) | listed, no stance (range 43260-43273) | Nov 13, 2025 | payer document |
| Aetna | Dysphagia Therapy (0625) | covered if criteria are met | Sep 25, 2025 | payer document |
| Aetna | Nerve Blocks (0863) | listed, no stance (range 43260-43278) | Jul 23, 2026 | payer document |
| Aetna | Photodynamic Therapy (0375) | listed, no stance | May 21, 2026 | payer document |
| Aetna | Radiofrequency Tumor Ablation (0492) Radiofrequency ablation (RFA) for adrenal gland | covered if criteria are met | Oct 5, 2026 | payer document |
| Aetna | Upper Gastrointestinal Endoscopy and Gastrointestinal Biopsy (0738) | covered if criteria are met (range 43233-43270) | Oct 29, 2025 | payer document |
| Anthem | Ablative Techniques as a Treatment for Barrett Esophagus (CG-SURG-101) | covered if criteria are met | May 14, 2026 | payer document |
| Anthem | Upper Gastrointestinal Endoscopy in Adults (CG-MED-59) | covered if criteria are met | May 14, 2026 | payer document |
| Blue Cross & Blue Shield of Mississippi | Endoscopic Radiofrequency Ablation Or Cryoablation For Barrett Esophagus | unproven / investigational | payer document | |
| Blue Shield of California | Endoscopic Radiofrequency Ablation or Cryoablation for Barrett Esophagus (2.01.80) | listed, no stance | payer document | |
| BlueCross BlueShield of South Carolina | Endoscopic Radiofrequency Ablation or Cryoablation for Barrett's Esophagus (CAM 20180) | listed, no stance | Jun 1, 2026 | payer document |
| Capital Blue Cross | Endoscopic Radiofrequency Ablation or Cryoablation for Barrett's Esophagus (MP 1.118) Procedure codes | covered if criteria are met | Feb 1, 2026 | payer document |
| Capital Blue Cross | Endoscopic Radiofrequency Ablation or Cryoablation for Barrett's Esophagus (MP 1.118) Procedure codes | unproven / investigational | Feb 1, 2026 | payer document |
| Centene | Ambulatory Surgery Center Optimization Reference Number: CP.MP.158 (CP.MP.158) | covered if criteria are met | Jun 1, 2022 | payer document |
| Centene | Anesthesiology Services for Gastrointestinal Endoscopy (CP.MP.161) | covered if criteria are met | May 1, 2019 | payer document |
| Health Care Service Corporation (BCBS IL, TX, OK, NM, MT) | Endoscopic Radiofrequency Ablation or Cryoablation for Barrett Esophagus (SUR709.033) | listed, no stance | Jan 1, 2026 | payer document |
From payers' published prior-auth lists, coverage policies and state Medicaid fee schedules, updated Oct 16, 2026. The role is what the policy's own code table or text says about the code. Not a guarantee of coverage or payment; verify with the payer. CPT® is a registered trademark of the American Medical Association.