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The two conditions: the procedures must be performed on completely separate and distinct anatomical sites, and modifier 59 (commercial) or XS (Medicare) must be applied to the lower-valued code with operative note documentation to match

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Due to faster bacterial turn-over at higher temperatures, we hypothesized (2) that community adaptation would be faster in response to increasing the temperature compared to in situ conditions (for the cold-adapted winter community), than in response to decreasing the temperature (for the warm-adapted summer community)

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