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If anesthetic injections indicate that the nerve is the source of pain, the next step is to block the pain signals more permanently

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After the pain has subsided, the patient is usually able to function normally because the short head is sufficient to take over flexion activities

They worsen symptoms when they relax the LES or increase stomach pressure

However, controlled combination studies with clear statistical endpoints are rare, so synergistic effects remain largely hypothetical at present

Response: We appreciate the commenter's recommendation regarding the APC assignment of CPT code 52597 (0421T) but we disagree that the clinical complexity and resource required for CPT code 52597 (0421T) is comparable to CPT code 55882