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These commenters stated that the C-APC methodology lacks the appropriate charge capture mechanisms to accurately reflect the services associated with the C-APC, that there are significant variations in the clinical practice and billing patterns in the hospital claims data used for ratesetting, and that the C-APC rates do not accurately or fully reflect the services and costs associated with the primary procedure

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Under some pathophysiological circumstances, endothelium-derived vasoconstricting factors, such as ET-1, AT-II, urotensin II, superoxide anions, vasoconstrictor prostaglandins and thromboxane A 2 , can be released and contribute to the paradoxical vasoconstrictor effects

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