The lack of clinical improvement after 48 weeks for anemia and after 612 months for neurological signs could suggest that the symptoms are not due to B12 deficiency or that the dose of vitamin B12 or the route of administration needs to be adjusted to the severity of symptoms
HCPCS code GPCM1 ( Initial psychiatric collaborative care management, in the first calendar month of behavioral health care manager activities, in consultation with a psychiatric consultant and directed by the treating physician or other qualified health care professional, with the following required elements: outreach to and engagement in treatment of a patient directed by the treating physician or other qualified health care professional, initial assessment of the patient, including administration of validated rating scales, with the development of an individualized treatment plan, review by the psychiatric consultant with modifications of the plan, if recommended, entering patient in a registry and tracking patient follow-up and progress using the registry, with appropriate documentation, and participation in weekly caseload consultation with the psychiatric consultant, and provision of brief interventions using evidence-based techniques such as behavioral activation, motivational interviewing, and other focused treatment strategies (list separately and in addition to the Advanced Primary Care Management code) )
Sufficient for about 150 applications
Improper mixing can damage the delicate molecules, reducing effectiveness or causing irritation at injection sites
