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Of these 23 articles, 7 were systematic reviews and/or meta-analyses, 15 were randomized clinical trials, non-controlled clinical trials, or observational studies, and 1 article related to practice guidelines

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Comment: One commenter said the reference to expected in the CMS proposal should have no impact on the utilization rates of Modifier -55 because Modifier -55 should not be appended to a claim unless post-operative management of patient care has actually occurred