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If there is a lack of cobalamin in the body, methylmalonyl CoA accumulates, which presumably leads to the neurological manifestations of B12 deficiency.47912 The replenishment with parenteral cyanocobalamin causes a rapid and complete improvement of megaloblastic anemia and gastrointestinal symptoms caused by vitamin B12 deficiency

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The ICD-10-CM Official Guidelines for Coding and Reporting FY2026 (CMS/NCHS) require the causative condition to be sequenced before the diabetes code