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Response: We do not agree that CPT code 64596 is an outlier in assigning the MPPR status to Y in that many other surgical procedures with significant device costs in the Neurostimulator and Related Procedures APC clinical family are also discounted under the MPPR policy, such as CPT code 64583 (Revision or replacement of hypoglossal nerve neurostimulator array and distal respiratory sensor electrode or electrode array, including connection to existing pulse generator)

In conclusion, diets without (lactose, gluten, ), in the absence of proven intolerance, do not improve overall human health, nor thyroid health