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The commenters identified this as a potential technical error and recommended that CMS update the PC/TC indicator for CPT code 38228 from a “5” to a “0” to appropriately capture the nature of the service and to align it with other similar services such as CPT codes 38240 and 38242

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To overcome these constraints, we propose that future prospective studies implement three key strategies: (1)Systematic collection of dietary and supplemental B12 data using standardized instruments such as food frequency questionnaires