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Metastatic coding: When the primary site is documented as resolved or resected and no further primary-site treatment is planned, the primary site may be coded as history of (Z85.x) while the metastatic site carries the active C79.x code but only when the physician has clearly documented treatment completion at the primary site

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Neurologic, cognitive, hematologic, or mucosal features can point to a shortfall, as can risk factors such as malabsorption, autoimmune gastritis, relevant medications, or nitrous oxide exposure

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