There is a clear and proven link between vitamin B12 deficiency and peripheral neuropathy
Initial response time also depends on: Severity of the B12 deficiency Frequency of injections Underlying health conditions Absorption and metabolism differences If youre getting your first B12 shot, your provider may start you on a more aggressive schedule, such as weekly injections until your levels are normalized
The above is usually talked of in terms of 'anaemia', but it does show that there is a complicated link between B12, B6, folic acid, zinc and vitamin D levels, chronic disease (anaemia of chronic disease) and how the body 'manages' serum iron, ferritin, and transferrin iron saturation and keeps these in balance (or not, as in your case)
Document the foreign body removal in the procedure note, but do not attempt to separately bill it alongside the repair code
Pernicious anemia occurs more commonly in people who already have diseases that are linked to immune-system abnormalities, such as Graves disease, hypothyroidism (under-functioning thyroid gland), thyroiditis (inflammation of the thyroid), vitiligo, and Addison's disease (adrenocortical insufficiency)