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For a 99214, the documentation should reflect at least moderate complexity in the number and complexity of problems addressed, the amount and complexity of data reviewed, and the risk of complications or management decisions

However, studies that raise these issues generally use alpha-tocopherol in isolation, as opposed to full-spectrum vitamin E (tocopherols and tocotrienols) and have other methodological weaknesses (Bryan 2023

New York: Wiley-Liss

Am J Reprod Immunol 75(3):208217

Over-the-counter products marketed as a lip dark spot remover may slightly lighten surface discoloration, but they rarely eliminate true sun spots, freckles, or smoking-related pigmentation