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Below we demonstrate the steps used to determine the APC payments that will be made in a CY under the OPPS to a hospital that fulfills the Hospital OQR Program requirements and to a hospital that fails to meet the Hospital OQR Program requirements for a service that has any of the following status indicator assignments: J1, J2, P, Q1, Q2, Q3, Q4, R, S, T, U, or V (as defined in Addendum D1 to this final rule with comment period, which is available via the internet on the CMS website), in a circumstance in which the multiple procedure discount does not apply, the procedure is not bilateral, and conditionally packaged services (status indicator of Q1 and Q2) qualify for separate payment

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Sepesi B, Swisher SG, Walsh GL, Correa A, Mehran RJ, Rice D, Roth J, Vaporciyan A, Hofstetter WL

5.3 Post-translational modification regulation of enzyme activity The activity of metabolic enzymes involved in the de novo serine synthesis pathway is precisely modulated by post-translational modifications such as methylation, ubiquitination and deacetylation ( Figure 3 ), and such regulatory patterns exhibit cancer-type specificity