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Vitamin B12, along with folate, is required as a significant determinant of one-carbon metabolism, which generates the compound called SAM (S-adenosylmethionine)

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In response to comments that a hospital would be required to (1) identify each patient discharge to which a particular rate applied, then (2) determine the MS-DRG that would have applied to that case, and then (3) calculate or determine an MS-DRG rate for that payer based on that claims history, we agree with the first two statements, but is it unclear what the commenters mean by the third statement with respect to the claims history

Harhai and Harsing 2022)