Indications and Usage for B-12 Compliance Injection Cyanocobalamin is indicated for vitamin B12 deficiencies due to malabsorption which may be associated with the following conditions: Addisonian (pernicious) anemia Gastrointestinal pathology, dysfunction, or surgery, including gluten enteropathy or sprue, small bowel bacteria overgrowth, total or partial gastrectomy Fish tapeworm infestation Malignancy of pancreas or bowel Folic acid deficiency It may be possible to treat the underlying disease by surgical correction of anatomic lesions leading to small bowel bacterial overgrowth, expulsion of fish tapeworm, discontinuation of drugs leading to vitamin malabsorption (see DRUG INTERACTION), use of a gluten-free diet in nontropical sprue, or administration of antibiotics in tropical sprue

Because it acts locally on growth factor pathways rather than endocrine receptors, typical side effects are restricted to localized injection site irritation or mild transit shifts in bowel motility models
Some requested CMS delay any changes in the threshold until the policy has been in place for at least 2 years
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