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Importantly, persistently high serum B12 in the absence of supplementation should prompt GP assessment, as it may indicate underlying disease processes

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8 A case-control study that compared 25,956 patients who had vitamin B 12 deficiency with 184,199 control patients found a significantly increased risk of vitamin B 12 deficiency in patients who had taken proton pump inhibitors (odds ratio = 1.65) or histamine H 2 blockers (odds ratio = 1.25) for at least two years

However, in general, if an item or service discussed by commenters does not qualify for separate payment under this provision, that does not mean that there are not other appropriate methods of coverage and payment available under the Medicare Act

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