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As fat is deposited between the skin and the muscle, the dimples are caused by the septae tightening the skin to the muscle between the pockets of fat, making the fat appear encircled in divots, or dimples

Without testing, there is no way to distinguish between B12 deficiency and other causes of similar symptoms, no way to determine the severity of deficiency, and no way to select the most appropriate delivery method

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[5] Importantly, if both B12 and folate deficiencies are present, B12 should be corrected first to avoid potentially worsening neurological symptoms

Therefore, linking the injection directly to the patient's condition ensures compliance with CMS and payer guidelines and strengthens the claim's validity