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Stevens explained, Because it may be appropriate to submit an [evaluation and management] charge on top of your infusion charges. If so, be sure to append modifier 25 Significant, separately identifiable evaluation and management (E/M) service by the same physician or other qualified healthcare professional on the same day of the procedure or other service to the E/M code

Also, high-dose B12 has been linked to acneiform eruptions in some case reports and reviews (Bahbouhi et al., 2023) as described in the PubMed record

It had long been known that the disease was associated with defects in the gastrointestinal tract: patients had chronic gastritis and lack of acid secretion (achlorhydria)

Maintaining a simple log takes seconds per entry and prevents the most common long-term protocol errors