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In addition to serum B12, more accurate markers include methylmalonic acid (MMA) and homocysteine levels , especially for people with MTHFR mutations

We also proposed at 512.760(b)(2)(ii) that ASM participants limit the request for beneficiary-identifiable claims data to Medicare beneficiaries who have been seen by ASM participants for an ASM targeted chronic condition, and who did not request to restrict sharing their claims data with the ASM participant, as proposed at 512.760(f)(1)

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However, MRI of whole spine and brain showed no evidence of subacute combined degeneration (SACD) of the spinal cord