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The following scenarios are commonly covered under applicable LCD policies, including Palmetto GBA L33418 and similar MAC policies: Anemia evaluation: unexplained macrocytic or megaloblastic anemia workup Neurological symptoms: peripheral neuropathy, subacute combined degeneration, cognitive decline, paresthesia Malabsorption states: celiac disease, Crohn’s disease, short bowel syndrome, atrophic gastritis, pernicious anemia Metformin use: long-term metformin therapy is associated with B12 depletion
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