This is risky for several reasons: Wrong patient selection, such as people with pancreatitis, gallstones, or severe kidney disease using them without screening Rapid, unsupervised dose escalation No monitoring of kidney, liver, pancreatic, or eye status Complications seen with unsupervised use include pancreatitis, dehydration-induced acute kidney injury (especially in hot Indian summers with vomiting or diarrhoea), and even diabetic ketoacidosis in susceptible individuals
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"This problem will be further exacerbated by the use of GLP-1 medications which decrease overall food intake
Without Modifier 59, the payer may bundle one into the other and pay only the higher-weighted code