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The commenter stated that with no appropriate clinical APC to use as an alternative, CMS should assign the procedure to a new technology APC that more closely aligns with its GMC

Both approaches can become messy if foundational sequencing is missing

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Hormonal influences, reproductive demands, and autoimmune conditions affecting gastric absorption (e.g., pernicious anemia, thyroid disease) may predispose women to deficiency, while greater health-seeking behavior increases test frequency

The Loading Phase: Refilling the Tank When you have pernicious anemia caused by autoimmune gastritis, your immune system has destroyed the stomach cells that produce intrinsic factor a protein necessary for absorbing vitamin B12 from food