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For 90847 to be separately billable alongside individual therapy, the family therapy component must constitute a separately identifiable service with a distinct therapeutic focus, conducted during a separate time interval from the individual therapy, and documented independently with its own clinical note or note section showing separate time allocation

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While observational and mechanistic studies suggest that disturbed one-carbon metabolism, elevated homocysteine, and mitochondrial dysfunction may contribute to neurodegenerative pathways, current evidence does not establish a direct causal link between B12 deficiency and Alzheimers disease

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