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The instructional note at the E11 category directs coders to use additional code for long-term (current) use of insulin (Z79.4). The clinical rationale is meaningful

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Spacing protein in smaller, more frequent servings can make it easier to meet protein needs when appetite is low, and may be better tolerated on GLP-1 medications, especially for those experiencing nausea or reflux

These inconsistent findings could be attributed to differences in the duration of treatment and the manner in which rates of EE are presented