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In this case, the rationale and technique associated with this code plus billing will greatly enhance the providers chance of obtaining a better outcome for the patient and proper reimbursement

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Malabsorption : Some people may have difficulty absorbing vitamin B12 from the diet due to certain medical conditions or the use of certain medications, such as proton pump inhibitors (PPIs) or H2 blockers, which reduce stomach acid production

Using expired b12 could certainly result in you not receiving the proper dosage due to deterioration as you now likely suspect given your setback