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Three things arent included and must be billed separately: the medication injected (billed via HCPCS J-codes), ultrasound guidance (if used, switch to CPT 20611 with permanent recording and reporting), and a separately identifiable evaluation and management service when a distinct clinical problem is addressed with modifier 25

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If you have conditions that make absorbing nutrients tricky, its worth speaking to your GP about supplements

A patient who hasn't had that conversation isn't receiving appropriate care, regardless of where they're sourcing their sermorelin