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The CY 2018 HH PPS proposed rule (82 FR 35320) and the technical report from December 2016, posted on the Home Health PPS Archive web page located at: provides a more detailed explanation as to the construction of these functional impairment levels using the OASIS items

Guideline 1: Proper Deficiency Diagnosis First, a Vitamin B12 deficiency must be accurately diagnosed

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Those with coeliac disease must avoid foods containing gluten, such as wheat (including varieties like spelt and kamut), barley, rye, and triticale