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First, scope of practice determines which codes a provider can bill

Patients who have undergone adjustable gastric banding , sleeve gastrectomy , or Roux-en-Y gastric bypass may respond differently, though high-quality comparative data is lacking

Although gastric banding carries a lower risk of B12 deficiency than malabsorptive procedures such as Roux-en-Y bypass, reduced tolerance of B12-rich foods and the use of acid-suppressing medicines can still compromise nutritional status over time

On the approval of a doctor, a person may wish to start a low dose and work upward slowly, increasing the dose once per week until they notice a difference