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Contraindications & Precautions Absolute Contraindications Known hypersensitivity to DMPS or sulfur-containing chelators Severe renal impairment (risk of accumulation and toxicity) History of Stevens-Johnson syndrome from sulfur-related drugs Uncontrolled asthma or severe atopy (higher risk of anaphylactic reactions) Relative Contraindications G6PD deficiency (risk of hemolysis) Pregnancy (unless life-saving toxicology situation) Breastfeeding Cardiovascular instability Toxicology-Specific Precautions Must ensure adequate hydration and renal perfusion Must monitor urine output , creatinine, BUN Correct electrolyte abnormalities Use caution in patients with metal implants (low risk but theoretical binding) IV-Specific Precautions Infuse under monitoring (BP, HR, respiratory status) Avoid rapid bolus Use sterile pharmaceutical-grade DMPS only Interactions A

Other commenters questioned whether use of HCPCS code G0559 would result in reliable data on the number of visits furnished by the operating surgeon or if it would confirm the care was related to the surgery