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(b) Background on Significant, Anomalous, and Highly Suspect Billing Activity Recently, ACOs and other interested parties have raised concerns about an increase in billing to Medicare for selected intermittent urinary catheter supplies on Durable Medical Equipment, Prosthetics, Orthotics & Supplies (DMEPOS) claims in CY 2023, alleging that the increase in payments represents fraudulent activity (the alleged conduct)

Mutations or polymorphisms in genes encoding enzymes involved in serotonin synthesis, transporters, and receptors can alter serotonin levels and signaling efficiency, thereby affecting the bidirectional regulation of the gut-brain axis (Kang et al., 2024)

Moreover, elevated hepatic enzyme activity can signify underlying inflammation, which can disrupt insulin signaling pathways

The fix is documentation discipline, not code avoidance