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The practical rule is that the presence or absence of documented counseling (not the patients age alone) determines whether 90471 or 90460 applies for pediatric patients

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They are often included as part of a broader wellness or pain management plan, especially for patients dealing with chronic conditions, inflammation, or nerve irritation

If you do not have any symptoms from your gastric cancer, it is unlikely that a complete removal of the stomach will be offered to you, as the surgery has only been shown to demonstrate benefit in patients suffering from severe and symptomatic disease (2)