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Common causes of this compression include any condition that increases pressure on the groin, including: (1) Tight clothing or belt (2) Obesity (3) Pregnancy (4) Ascites (5) Scoliosis (6) Walking, cycling or standing for long periods of time It can also occur as a result of: (1) Nerve dysfunction due to diabetes, hypothyroidism, alcohol or lead poisoning (2) Nerve dysfunction due to Vitamin B12 or folate deficiency (3) Nerve injury such as a seat belt injury in a motor vehicle accident (4) Nerve trauma resulting in a neuroma, an overgrowth of nerve fibers and connective tissue (5) Nerve injury during surgery, especially laparoscopic inguinal hernia repair (6) Scar tissue near the inguinal ligament, due to injury or past surgery of the lower abdomen/pelvis Physical Exam Isolated compression or lesions of the LFCN result only in abnormalities on sensory examination

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Another commenter stated that adding these measures to the APP Plus quality measure set would increase administrative burden specifically for Shared Savings Program ACOs beginning in 2025 since they would be required to report all measures in the APP Plus quality measure set