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Modifier 22 Increased Procedural Services Modifier 22 may be reported when the procedural work exceeds the typical effort required for 20610, such as when significant joint edema, severe synovitis, or complex fluid aspiration requires prolonged or technically difficult manipulation

Symptoms associated with vitamin B12 deficiency include fatigue and lack of energy (due to anaemia), and depression, psychosis and even dementia

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This amazing sequence of events usually unfolds without a hitch but every once in a while, things dont go according to plan

I dont know why (nor could my doctors figure it out) but around five years ago at age 60 my body apparently stopped absorbing B12 through my digestive system