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B12 Supplements (MAJOR EFFECT) Oral B12 Supplements: Typical dose: 1000 mcg (1 mg) Absorption: ~1-2% passively absorbed (10-20 mcg from 1000 mcg dose) Effect on serum B12: Can increase by 100-300 pg/mL within 24 hours Peak effect: 4-8 hours after oral supplement Intramuscular B12 Injections: Dose: Usually 1000 mcg Effect: Massive increase in serum B12 Can reach 1000-5000 pg/mL within hours Sustained elevation for weeks Recommendation: Stop oral supplements 3-7 days before testing (ideally 7 days) Wait 1-2 weeks after injection before testing 2

Alternatively, providers can select 99212 based on straightforward medical decision making, which carries no minimum time requirement at all

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