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Your ideal timing will depend on your routine and clinician guidance

In the CY 2017 OPPS/ASC final rule with comment period (81 FR 79796), we clarified that the reporting ratio does not apply to codes with status indicator Q4 because services and procedures coded with status indicator Q4 are either packaged or paid through the Clinical Laboratory Fee Schedule and are never paid separately through the OPPS

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Use HCPCS J-codes for the drug itself

Vitamin B12 plays a critical role in supporting red blood cell formation, neurological health, and DNA synthesisdeficiencies can lead to fatigue, mood changes, and cognitive decline

It should never be administered intravenously by itself , because it contains no salts and is hypotonic