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This case highlights that vitamin B12 deficiency can manifest primarily as deep sensory disturbance without typical upper motor neuron signs or radiological findings, particularly in older adults

[2] The MHRA Drug Safety Update (August 2022) advises healthcare professionals to consider testing vitamin B12 levels in patients taking metformin who develop symptoms of neuropathy or anaemia, and to consider periodic monitoring in those at risk of deficiency

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Issue 1: Missing or Incorrect Modifier The single most common approval issue is submitting 96372 without the correct modifier when one is required

Always receive a full demonstration from your vet before attempting home administration.

They are usually mild and improve as eating and hydration stabilise