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Common plans are: Initial loading phase: Daily or weekly shots for the first few weeks Maintenance phase: Monthly shots after the initial phase The exact schedule depends on the patients needs and test results

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Others may need to discontinue if symptoms are intolerable

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The 20611 cpt code description adds with ultrasound guidance, with permanent recording and reporting as the only difference between the two codes

In such cases, the focus should shift to investigating potential underlying causessuch as myeloproliferative disorders, liver disease, or renal dysfunctionrather than attributing symptoms to the elevated B12 itself