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In the CY 2017 OPPS/ASC final rule with comment period (81 FR 79796), we clarified that the reporting ratio does not apply to codes with status indicator Q4 because services and procedures coded with status indicator Q4 are either packaged or paid through the Clinical Laboratory Fee Schedule and are never paid separately through the OPPS

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However, when something disrupts this delicate balance, such as a pinched nerve, it can lead to discomfort and pain