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Some might argue that a low threshold for B 12 therapy is reasonable as a preventative measure, rather than waiting for symptomatic deficiency to develop

So this is the response from my doctor

A lack of B12 in the body can cause reversible damage to the myelin sheath that protects the nerves in our feet and legs, resulting in neurological symptoms (Ekabe et al., 2017)

Inappropriate diet, excessive levels of salt or phosphates, dehydration, low potassium levels, hypertension, and anemia can make kidney disease worse.

Modifier 51 Multiple Procedures Modifier 51 is used when 20610 is performed alongside other procedures in the same encounter