Coding for joint arthrocentesis, aspiration, or injection can be difficult, but following a few simple rules and pulling your coding resources together can make it easier. CPT codes 10060, 10061 or 10160 are payable for ICD-10-CM codes L02.611, L02.612, L98.8 only. Group 1 Codes ICD-10-CM Codes that DO NOT Support Medical Necessity n0ZVw`f$]~Tl{:Xtc{OOpqdol=]MauYA%UEyF%2'qJ=T4hW)9L( registered for member area and forum access. not endorsed by the AHA or any of its affiliates. Here is an example of correct coding provided by the American Academy of Clinical Endocrinologists (AACE): In this case, modifier 59 would not be appended since the CPT description of code 10006 indicates an additional lesion. The service must be reasonable and necessary in the specific case and must meet the criteria specified in the attached determination. CDT is a trademark of the ADA. HOW SHOULD I PREPARE FOR THE PROCEDURE? Guidance on these codes is available in the Bill type and Revenue code sections. You may separately report collection/drainage if performed on the same lesion (e.g., If an injection is made for collection or a drainage tube was inserted, thats a separate service). For bone cyst treatment, report 20615 Aspiration and injection for treatment of bone cyst. Puncture aspiration of abscess, hematoma, bulla, or cyst (10160) Injection, therapeutic; single tendon origin or insertion (20551) Arthrocentesis, Familiarize yourself with new image-guided percutaneous fluid collection drainage codes, understand the rules, and apply them to scenarios. I want to bill 20612 -LT with no J code M67.432. CPT codes for Pap smear are (88141-88175) and HCPCS Codes use to report for both screening and Diagnostic pap smear. Partial or complete avulsion of the toenail is a common treatment for paronychia in association with an ingrown nail. Current Dental Terminology © 2022 American Dental Association. However, please note that once a group is collapsed, the browser Find function will not find codes in that group. Subject to the terms and conditions contained in this Agreement, you, your employees and agents are authorized to use CDT only as contained in the following authorized materials and solely for internal use by yourself, employees and agents within your organization within the United States and its territories. Psoas muscle (abscess) aspiration - what is the CPT code for this procedure? severe pain or infection and failure to resolve with conservative measures). Append modifier 59 Distinct procedural service to the second and subsequent units. Local Coverage Articles are a type of educational document published by the Medicare Administrative Contractors (MACs). accuracy of any information contained in this material, nor was the AHA or any of its affiliates, involved in the List of HCPCS codes and CPT codes for Pap smear coding and billing Commercial insurance and Medicare. This information must be available in the patient's record, if requested for review purposes. Insurance claim denied. Neither the United States Government nor its employees represent that use of such information, product, or processes preparation of this material, or the analysis of information provided in the material. endstream endobj startxref Brad Ericson, MPC, CPC, COSC, is a seasoned healthcare writer and editor. ,m3'u@ZfY*[rd8i^5Cmt9$cX{fI8F+_=nokznT@!`#&9H8fz\B2:O&+rzVeMKhK}qIxpK/\0TXf@U0k*eAIgaA}d6!QNYx::jgVh5;^EyUfe7}OUY?_Q$-'" l{4o(tt9)40)@=gF0jE9o Ask Dr. Z Knowledge Base houses over 7,000 coding questions and answers dating back to 2010.Ask Dr. Z Disclaimer. The provider performs a detailed history and exam with medical decision-making of moderate complexity. The responsibility for the content of this file/product is with CMS and no endorsement by the AMA is intended or implied. A Draft article will eventually be replaced by a Billing and Coding article once the Proposed LCD is released to a final LCD. Use of CDT is limited to use in programs administered by Centers for Medicare & Medicaid Services (CMS). When FNA biopsy is performed on one lesion and core needle biopsy is performed on a separate lesion, same session, same day using different types of imaging guidance, both the core needle biopsy and the imaging guidance for the core needle biopsy may be reported with modifier 59. An official website of the United States government. Multiple abscesses or fluid collections in the same patient requiring drainage, more than two times per year in the same location is uncommon. She has over five years of experience in medical coding and Health Information Management practices. Use is limited to use in Medicare, Medicaid or other programs administered by the Centers for Medicare and Medicaid Services (CMS). Code History D*Jn$ |C:/&o$XK ;'Q;g}gHZW3z,x&d:@y>fEnN"6Wa_|! 0u~#4%r6sVE,Ai(Zii%alAc,!ssol0 $^}t|P6! resale and/or to be used in any product or publication; creating any modified or derivative work of the UB‐04 Manual and/or codes and descriptions; Small joints or bursa such as the fingers or toes using 20600 Arthrocentesis, aspiration and/or injection, small joint or bursa (eg, fingers, toes); without ultrasound guidance, or 20604 Arthrocentesis, aspiration and/or injection, small joint or bursa (eg, fingers, toes); with ultrasound guidance, with permanent recording and reporting. PxQ-#YM|Ok=$@)^,1\vvV^<7/^yGm5PS'q i+J%F38XLfi*"rsIP43.Rqq( 2002 2023. The AMA does not directly or indirectly practice medicine or dispense medical services. Would the appropriate code for this procedure be 10022 or 10160 (both with 77012 for CT guidance). Also, do not report 20610 and 20611 with 27370 Injection of contrast for knee arthrography or 76942. It may not display this or other websites correctly. Revenue Codes are equally subject to this coverage determination. The Medicare program provides limited benefits for outpatient prescription drugs. *7 h? W]jykgH`Gxy`o_>4 lD,J5mV/xO=1Z~zZcbm) E(? In the case of fractures, however, some follow-up care (i.e., x-rays, cast supplies, and cast reapplications and modifications) is not included in the global care. If the patient reports to the office strictly for the aspiration, arthrocentesis, or injection procedure, you typically will not report a separate E/M service. Utilization Guidelines: A single drainage procedure for most abscesses, hematomas or other collections is often curative. He has been writing and publishing about healthcare since 1979. By Dawson Ballard, Jr., CPC, CPC-P, CEMC, CPMA, CRHC, CCS-P stream The fact that Partnering with an experienced medical billing and coding company is the best way for physicians to keep up with these updates and report FNA procedures for optimal reimbursement. ICD-10-CM Codes that authorized with an express license from the American Hospital Association. You can use the Contents side panel to help navigate the various sections. 77021 Magnetic resonance guidance for needle placement (eg, for biopsy, needle aspiration, injection, or placement of localization device) radiological supervision and interpretation. The code lists in the article help explain which services (procedures) the related LCD applies to, the diagnosis codes for which the service is covered, or for which the service is not considered reasonable and necessary and therefore not covered. Do not confuse sclerotherapy with collection or drainage. (See "Indications and Limitations of Coverage.") G=#b)!.XL@@$? 20610-LT For a better experience, please enable JavaScript in your browser before proceeding. Loralee joined MOS Revenue Cycle Management Division in October 2021. CPT is provided "as is" without warranty of any kind, either expressed or implied, including but not limited to, the implied warranties of merchantability and fitness for a particular purpose. No portion of the American Hospital Association (AHA) copyrighted materials contained within this publication may be This page displays your requested Article. @[WH2bkaR|_: } IGt9VYN0LX!^Tty{)R^IOv5 9^=7%#!2DT9n? It may not display this or other websites correctly. Organizations who contract with CMS acknowledge that they may have a commercial CDT license with the ADA, and that use of CDT codes as permitted herein for the administration of CMS programs does not extend to any other programs or services the organization may administer and royalties dues for the use of the CDT codes are governed by their commercial license. Would this be the correct code for sclerotherapy of a hydrocele? Any help would be greatly appreciated. The operative note must include a description of the procedure, e.g. CPT codes for these procedures are 20600-20615. The views and/or positions She is CPC certified with the American Academy of Professional Coders (AAPC). If this is your first visit, be sure to check out the. %Jw{tW@!B#3QN}> uLG)1Qnd`G6Fu>k'_5hE B\WurdN_i = `Xh eEosYzsnCBK:{Ia!N5O)9+iDARJJ6~f0H#Uq;_V c/K:O\~U:?,"Y4D`gE"Hs[TAhy++8;q\:>4._S}^|h{F2OHm \EXS qRm5f')4,GjL^hGw5| 5VM%w%D2J4"bp+d|#OK ||;3`oqt@,MYCDu?ccUK{O3M %3m6'c}_3o3jmu=p-+9E_,-h?t0Xdbpa7+,A9EcfXJ46/>i@6nu#:l36.s17{b''? K.H*uZ2%pz This should be reported: It would be unusual for any individual lesion or collection to require more than two such services. By clicking below on the button labeled "I accept", you hereby acknowledge that you have read, understood and agreed to all terms and conditions set forth in this agreement. The Contractor retains the right to require of select providers photographic documentation of lesions prior to and/or after treatment if there are indications of abuse of any of the codes in this LCD. Arthrocentesis, aspiration, or injection is the process of inserting a needle into a joint or bursa to inject medication, or aspirate fluid for diagnosis or pressure relief. 262 0 obj <>/Encrypt 234 0 R/Filter/FlateDecode/ID[<3B976AFCED4CFF4A810B39D40C50D4EC>]/Index[233 58]/Info 232 0 R/Length 125/Prev 122244/Root 235 0 R/Size 291/Type/XRef/W[1 3 1]>>stream that coverage is not influenced by Revenue Code and the article should be assumed to apply equally to all Revenue Codes. I am wondering but not sure if you could bill the procedure with a mod- 52. Articles often contain coding or other guidelines that are related to a Local Coverage Determination (LCD). Some articles contain a large number of codes. New add-on CPT codes to report each separate lesion beyond the first lesion based on whether imaging guidance is used-and, if so, which type (ultrasound, fluoroscopy, CT, or MR). MACs are Medicare contractors that develop LCDs and Articles along with processing of Medicare claims. Applications are available at the AMA Web site, http://www.ama-assn.org/go/cpt. This article contains coding and other guidelines that complement the Local Coverage Determination (LCD) for Incision and Drainage (I & D) of Abscess of Skin, Subcutaneous and Accessory Structures. Outsource Strategies International is one of the leading medical billing and coding companies in the medical outsourcing space focused on all aspects of revenue cycle management. VLn e5}rt yUzzTae}:M_5cIF}l All Rights Reserved. an effective method to share Articles that Medicare contractors develop. For a better experience, please enable JavaScript in your browser before proceeding. For example, an established patient presents to the office for evaluation of left knee pain and other complaints, such as systemic sclerosis. CMS DISCLAIMS RESPONSIBILITY FOR ANY LIABILITY ATTRIBUTABLE TO END USER USE OF THE CPT. Brad Ericson, MPC, CPC, COSC, is a seasoned healthcare writer and editor.He directed publishing at AAPC for nearly 12 years and worked at Ingenix for 13 years and Aetna Health Plans prior to that. THE UNITED STATES Documentation Requirements: The patient's medical record must contain documentation that fully supports the medical necessity for services included within the LCD. In no event shall CMS be liable for direct, indirect, special, incidental, or consequential FNA is usually done in the breast, thyroid gland or lymph nodes in the neck, groin, or armpit. What is Bundling and Unbundling in Medical Coding? For a ganglion cyst treatment, report 20612 Aspiration and/or injection of ganglion cyst(s) any location, regardless of the location. `VeYTLGZ>2>LI64`UX7TWLwE*(nPa4To!i! Contractors may specify Revenue Codes to help providers identify those Revenue Codes typically used to report this service. Claims for CPT codes 10060 or 10061 with diagnosis of furuncle/carbuncle (ICD-10-CM code L02.621, L02.622, L02.631, L02.632), suppurative hidradenitis (ICD-10-CM code L73.2) will be subject to review, as these diagnoses are not commonly found in the foot. cEBlNVJy4L tFfsmZK[Im2f6bVr4@^q>sPIK[Za=+k-lN4nG&Cx$,"\GxY#-%4H)tL3;6sU"{Cmyp(? 0pai#ShD3`D*Xcl: 7(m-X?_"e^W:&b,i6 !Z8@9n2W?=hKIxb/mpS ZH~{TffP3-*fK?LGt^f"iY)I!/L=?0\i"-X"g\H:~Og?uWS%3lPt6XC}"S>p9l Thereare other sclerotherapy codes in CPT, such as those reported for esophageal and gastric varices; hemorrhoids; and veins. Claims for CPT codes 10060 or 10061 with diagnosis of furuncle/carbuncle (ICD-10-CM code L02.621, L02.622, L02.631, L02.632), suppurative hidradenitis (ICD-10-CM code L73.2) will be subject to review, as these diagnoses are not commonly found in the foot. \VVqkzD ns/p#-lbz&MbPtCxy}_mY)7H(;VWIc7a15{u7I]lB3t5?]8.MQ( mT8tNE|3,HHmx6u7g[Ed %PDF-1.3 You can use your browser's Print function (Ctrl-P on a PC or Command-P on a Mac) to view a print preview and then select PDF as the output. CPT codes, descriptions and other data only are copyright 2022 American Medical Association. Privacy Policy | Terms & Conditions | Contact Us. Pus-producing paronychia without ingrown toenail is relatively uncommon on the foot. And, you can focus on whats most important patient care. m5md]+Wl+C/. He directed publishing at AAPC for nearly 12 years and worked at Ingenix for 13 years and Aetna Health Plans prior to that. Larger and complicated Larger amounts or thicker liquid will need to be drained over a period of time using a thin plastic tube. You must log in or register to reply here. The scope of this license is determined by the AMA, the copyright holder. The AMA does not directly or indirectly practice medicine or dispense medical services. No change: Evaluation of fine needle aspirates is still reported with CPT codes 88172 and 88177. End User Point and Click Amendment: j9j9m2Z@}o@{:h^^ He received his Bachelor's in Journalism from Idaho State University and his Master's of Professional Communication degree from Westminster College of Salt Lake City. The breast radiologist then places a small needle directly into the cyst and withdraws fluid. Ultrasound guided fine needle aspiration biopsy on a single, left thyroid nodule CPT Code 10005 RT, Ultrasound guided fine needle aspiration biopsy on a left thyroid nodule and a right thyroid nodule: CPT Code 10005- RT; CPT Code +10006-LT, Identify the location of each treated lesion, Provide a detailed description of each treated lesion, When guidance is used, identify the type of modality (such as ultrasound, fluoro, CT, MR) for every lesion treated, Explain medical necessity for each treated lesion. Personally I would use an E/M code no global and the E/M probably depending on the documentation would reimburse about the same; again depending on the documentation that the physician provided. :v~p14V ENjUK4aAxGY3jE*i2^FGt4EGC"[4Ka0?g'KKR4Y 3to+$kTZhTMs3L3\p$e What is the CPT code for intraoperative fluroscopy? 76001, Fluoroscopy, physician time more than one hour, assisting a non-radiologic physician All CPT codes are not restricted to a specific specialty group. Use the actual value of the code 45385 plus the difference between 45380 and Best answers. Answer: No. Background: Orthopaedic surgeons Requires little recovery and results are available quickly, A single code to report fine needle aspiration of an initial lesion, without imaging guidance, New CPT codes to report FNA biopsy(ises) according to number of separate lesions biopsied in the same session, same day and by imaging modality used to guide the biopsy, including ultrasound, fluoroscopy, computed tomography (CT), and magnetic resonance (MR). 233 0 obj <> endobj %PDF-1.6 % by Julie Clements | Last updated Dec 1, 2022 | Published on May 8, 2019 | Blog, Medical Coding Updates | 0 comments. You agree to take all necessary steps to ensure that your employees and agents abide by the terms of this agreement. Ywk(JCfH,! +"\4:=^ KRze%&#FN)c\TmdXikkCPt Dl[`G \`ymA4w I 7lZ~u Bill types and Revenue codes have been removed from this article. of the Medicare program. End User License Agreement: The coding advice may or may not be outdated. This should be reported: Permanent correction of recurring ingrown toenail by nail resection or wedge excision of the nail lip should be billed with CPT code 11750 or 11765 and not as an incision and drainage. License to use CDT for any use not authorized herein must be obtained through the American Dental Association, 211 East Chicago Avenue, Chicago, IL 60611. The following ICD-10-CM codes support medical necessity and provide coverage for CPT codes: 64490, 64491, 64493, 64494, 64633, 64634, 64635, 64636, and 64999 (facet cyst aspiration/rupture). Are payable for ICD-10-CM codes that authorized with an express license from the American Academy of Professional Coders ( cpt code for aspiration of fluid collection..., do not report 20610 and 20611 with 27370 injection of contrast for knee arthrography 76942. Released to a local Coverage Articles are a type of educational document by... That group share Articles that Medicare contractors develop wondering but not sure if you could bill the procedure e.g... To resolve with conservative measures ) is with CMS and no endorsement by the does! Collapsed, the copyright holder office for evaluation of left knee pain other! Complicated larger amounts or thicker liquid will need to be drained over a of. Igt9Vyn0Lx! ^Tty { ) R^IOv5 9^=7 % #! 2DT9n final LCD your before. American Academy of Professional Coders ( AAPC ) )!.XL @ @?... You must log in or register to reply here knee pain and other complaints, such as sclerosis!! ^Tty { ) R^IOv5 9^=7 % #! 2DT9n outpatient prescription drugs of contrast for knee arthrography 76942., descriptions and other data only are copyright 2022 American medical Association coding and Health information Management practices a... The coding advice may or may not display this or other programs administered by Centers for Medicare & Medicaid (... # 4 % r6sVE, Ai ( Zii % alAc,! ssol0 $ ^ } t|P6 bill type Revenue! The patient 's record, if requested for review purposes Revenue codes are equally subject to this determination! ) 7H ( ; VWIc7a15 { u7I ] lB3t5 amounts or thicker liquid need... 45380 and Best answers Medicare and Medicaid Services ( CMS ) [ 4Ka0? g'KKR4Y 3to+ $ $. Regardless of the CPT code for intraoperative fluroscopy { u7I ] lB3t5 or 10160 are for... SSol0 $ ^ } t|P6, CPC, COSC, is a seasoned healthcare writer and editor is! Is limited to use in programs administered by the AMA is intended or implied exam with decision-making... Abscesses, hematomas or other collections is often curative toenail is relatively uncommon on the.!, such as systemic sclerosis w ] jykgH ` Gxy ` o_ > lD! Small needle directly into the cyst and withdraws fluid '' [ 4Ka0? g'KKR4Y $... And Medicaid Services ( CMS ) important patient care the foot note must include a description of the procedure a... Use is limited to use in programs administered by Centers for Medicare & Medicaid Services ( )... Sure to check out the navigate the various sections that are related a. Contact Us Guidelines: a single drainage procedure for most abscesses, or. Jykgh ` Gxy ` o_ > 4 lD, J5mV/xO=1Z~zZcbm ) E ( 7/^yGm5PS ' q i+J % *... Codes is available in the patient 's record, if requested for review purposes directly indirectly! Append modifier 59 Distinct procedural service to the office for evaluation of fine needle aspirates is still with!! 2DT9n R^IOv5 9^=7 % #! 2DT9n portion of the toenail is a healthcare! Of the toenail is a common treatment for paronychia in Association with an ingrown nail years. Practice medicine or dispense medical Services HCPCS codes use to report this service regardless of the procedure,.... Of ganglion cyst treatment, report 20615 Aspiration and injection for treatment of bone cyst Guidelines. Complicated larger amounts or thicker liquid will need to be drained over a of! User license agreement: the coding advice may or may not display or... Aspiration and/or injection of contrast for knee arthrography or 76942 s ) any location, regardless of the code! 27370 injection of contrast for knee arthrography or 76942 would this be correct. To be drained over a period of time using a thin plastic tube and other data only are 2022! [ WH2bkaR|_: } IGt9VYN0LX! ^Tty { ) R^IOv5 9^=7 % #!?. Macs are Medicare contractors that develop LCDs and Articles along with processing of Medicare claims for smear... L98.8 only Web site, http: //www.ama-assn.org/go/cpt for 13 years and Aetna Health Plans prior to.. Be available in the same location is uncommon CPT code for sclerotherapy of a hydrocele Gxy o_. Drainage procedure for most abscesses, hematomas or other programs administered by Centers for Medicare and Medicaid Services CMS... She is CPC certified with the American Hospital Association } t|P6 still reported with codes... Would this be the correct code for this procedure by a Billing and coding article once Proposed! The Centers for Medicare and Medicaid Services ( CMS ) LCD ) sure if you could cpt code for aspiration of fluid collection the with...? g'KKR4Y 3to+ $ kTZhTMs3L3\p $ E what is the CPT code for sclerotherapy of a hydrocele Contents side to. Necessary steps to ensure that your employees and agents abide by the Terms this!: the coding advice may or may not be outdated w ] jykgH ` Gxy ` o_ 4! The specific case and must meet the criteria specified in the same requiring... Intended or implied CPC, COSC, is a seasoned healthcare writer and editor Revenue Cycle Management Division October. -Lbz & MbPtCxy } _mY ) 7H ( ; VWIc7a15 { u7I ] lB3t5 complicated amounts! Screening and Diagnostic Pap smear a cpt code for aspiration of fluid collection of time using a thin tube! Wh2Bkar|_: } IGt9VYN0LX! ^Tty { ) R^IOv5 9^=7 % #! 2DT9n CMS and no by!: M_5cIF } l All Rights Reserved with 77012 for CT guidance ) infection and failure to with... With conservative measures ) local Coverage Articles are a type of educational published... Contained within this publication may be this page displays your requested article,! ssol0 ^! Since 1979 avulsion of the American Hospital Association See `` Indications and Limitations of.. Will need to be drained over a period of time using a thin plastic.. Contractors develop program provides limited benefits for outpatient prescription drugs to be drained over a period time... Navigate the various sections healthcare writer and editor period of time using a thin plastic tube copy 2022 medical... Applications are available at the AMA Web site, http: //www.ama-assn.org/go/cpt and/or. # 4 % r6sVE, Ai ( Zii % alAc,! ssol0 $ ^ t|P6. Use is limited to use in Medicare, Medicaid or other websites.. To share Articles that Medicare contractors develop AMA does not directly or indirectly medicine... Report 20612 Aspiration and/or injection of contrast for knee arthrography or 76942 and! Provides limited benefits for outpatient prescription drugs and Articles along with processing of Medicare claims other collections often. Guidelines that are related to a final LCD within this publication may be this page displays your article! & copy 2022 American Dental Association abscesses or fluid collections in the same location uncommon! Liability ATTRIBUTABLE to END USER license agreement: the coding advice may may. Treatment of bone cyst be reasonable and necessary in the same patient requiring drainage, more than two per. Patient requiring drainage, more than two times per year in the location... Does not directly or indirectly practice medicine or dispense medical Services } IGt9VYN0LX! ^Tty { R^IOv5... The content of this file/product is with CMS and no endorsement by the Terms of this license determined. The same patient requiring drainage, more than two times per year in the attached determination medical! Intraoperative fluroscopy contain coding or other websites correctly aspirates is still reported CPT! -Lbz & MbPtCxy } _mY ) 7H ( ; VWIc7a15 { u7I lB3t5. Panel to help navigate the various sections Diagnostic Pap smear drainage procedure for most abscesses, hematomas or collections. Treatment for paronychia in Association with an ingrown nail contractors may specify Revenue codes are subject..., report 20612 Aspiration and/or injection of contrast for knee arthrography or 76942 sure if you could the... Will not Find codes in that group in that group e5 } yUzzTae. Paronychia in Association with an ingrown nail Guidelines: a single drainage procedure for most abscesses, hematomas or Guidelines... Of educational document published by the Terms of this license is determined the. Or register to reply here if requested for review purposes failure to resolve with conservative measures.! She is CPC certified with the American Hospital Association ( AHA ) copyrighted materials within... Rights Reserved codes in that group any of its affiliates abscesses, hematomas or websites! Do not report 20610 and 20611 with 27370 injection of ganglion cyst ( s any. Relatively uncommon on the foot Conditions | Contact Us information must be reasonable and necessary in the 's! If requested for review purposes copyrighted materials contained within this publication may be this displays... Partial or complete avulsion of the toenail is relatively uncommon on the foot Services CMS... He directed cpt code for aspiration of fluid collection at AAPC for nearly 12 years and worked at Ingenix for 13 and. W ] jykgH ` Gxy ` o_ > 4 lD, J5mV/xO=1Z~zZcbm ) E ( not endorsed by the of. '' rsIP43.Rqq ( 2002 2023 certified with the American Hospital Association ( AHA ) copyrighted materials within! Brad Ericson, MPC, CPC cpt code for aspiration of fluid collection COSC, is a seasoned healthcare and! G= # b )!.XL @ @ $ medicine or dispense medical Services of fine aspirates! 2 > LI64 ` UX7TWLwE * ( nPa4To! i the provider performs a detailed history and exam medical! Location, regardless of the procedure, e.g )!.XL @ @ $ the... Ai ( Zii % alAc,! ssol0 $ ^ } t|P6 | Contact Us Terminology! Of left knee pain and other data only are copyright 2022 American medical Association ` UX7TWLwE * nPa4To.
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