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Assessing results versus side effects The fundamental question is whether benefits justify any discomfort experienced

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The product is designed for the particular purpose indicated on the label

To determine which combinations of primary service codes reported in conjunction with an add-on code may qualify for a complexity adjustment for CY 2026, we apply the frequency and cost criteria thresholds discussed above, testing claims reporting one unit of a single primary service assigned to status indicator J1 and any number of units of a single add-on code for the primary J1 service