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Guideline 1: Tailoring B12 Therapy to Underlying Causes Effective B12 therapy needs a personalized touch

[104] [105] Deficiency does not develop if dietary intake of vitamin B 12 is adequate or prophylactic B 12 supplementation is given

Nature Medicine 21(8):887-894

Modifier 25 should be appended to the E/M code (not to 90471) to indicate the office visit was a distinct service beyond the vaccine administration

Some of the roles that are attributed to vitamin B12 include: Forming red blood cells Playing a role in DNA/RNA synthesis Acting as a cofactor for methionine synthase (helping with methylation or the conversion of homocysteine to methionine, which protects cardiovascular health and more) Facilitating metabolic conversion of protein and fats Carrying out neurotransmitter functions and helping with production of hormones Helping convert amino acids and make creatine Producing myelin sheath (the coating of nerves) Helping with synthesis of hemoglobin Playing a role in fetal development during pregnancy Vitamin B12 levels are usually tested with a blood serum test, and values below approximately 170250 picogram per milliliter in adults are considered signs of deficiencies

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