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64590: Insertion or replacement of peripheral, sacral, or gastric neurostimulator pulse generator or receiver, requiring pocket creation and connection between electrode array and pulse generator or receiver

It occurred in 0.5% of pregnancies in the UK and other Western countries before prophylaxis with folic acid, but the incidence is much higher in countries where the general nutritional status is poor

Neuroimaging (MRI of the spinal cord) may occasionally be warranted to exclude other pathology or to demonstrate the characteristic changes of subacute combined degeneration, though this is not routinely required for diagnosis