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Packaging payment for these drugs and biologicals that appear on a hospital outpatient claim with a primary C-APC service is consistent with our C-APC packaging policy under which we make payment for all items and services, including all non-pass-through drugs, reported on the hospital outpatient claim as being integral, ancillary, supportive, dependent, and adjunctive to the primary service and representing components of a complete comprehensive service, with certain limited exceptions (78 FR 74869)
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These include: Paraesthesia (pins and needles) in hands and feet Difficulty walking or balance problems Memory impairment and cognitive changes Mood disturbances, including depression and irritability Visual disturbances (rare, such as optic neuropathy) Gastrointestinal symptoms such as diarrhoea, constipation, or loss of appetite may also occur, particularly when deficiency results from malabsorption
This area should be presented with greater caution than the gastrointestinal and cell-migration literature because the mechanistic questions are more difficult
How Can Vitamin B12 Affect the Skin