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Point32Health Medical Necessity Guideline updates
Harvard Pilgrim Health Care·Effective Jun 1, 2026
CPT 43249 is officially defined as "Esoph egd dilation <30 mm." CPT 43249 is referenced in 1 tracked payer policy change from Harvard Pilgrim Health Care. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for CPT 43249 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.
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