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Additionally, we finalized our proposals to remove the same entity exception from the CMS EPCS Program and to add subject to the exemption in paragraph (a)(3)(iii) of this section to 423.160(a)(5) (88 FR 79287 through 79288)

Compounded tirzepatide is a custom-made medication that is manufactured by compounding pharmacies to meet patients needs and is not approved or reviewed by the FDA

Common symptoms include pain (often a dull ache that worsens at night), weakness (difficulty lifting the arm), stiffness (decreased range of motion), and clicking or popping sounds during shoulder movement

The commenter also stated that add-on codes should not be used for assignment ( because they are not distinct from the base code and would inappropriately weight the encounter. Another commenter stated that they did not support the inclusion of the interprofessional consultation codes, except for 99452, as they are usually performed by neurologists, cardiologists, internal medicine sub-specialties, and NPs/PAs (whose specialty affiliation is unknown)