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As fat tissue grows and more NNMT is produced, higher amounts of hormones and pro-inflammatory signals are produced that are responsible for weight gain and other chronic diseases such as type 2 diabetes and cardiovascular disease. NNMT is responsible for converting nicotinamide (NA) into 1-methylnicotinamide (1-MNA), which takes it out of the NAD salvage pathway (see the diagram below)

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Coexisting Illnesses B12 deficiency is often paired to other deficiencies or illnesses

## **Documentation requirements for J2350** As with any procedure, especially involving injecting drugs into patients, it's important to document the following before you file for a claim that includes this code: - The full name of the personnel who administered the injection + their credentials - The name and address of the facility where the injection was administered - The physician's order for this injection - The full name of the patient - The date and time of the drug administration by injection, including the NDC number of the injection - Patient records showing they have been diagnosed with a type of multiple sclerosis (e.g., primary progressive MS, relapse-remitting MS, etc.) - Patient records showing any other active disease - Patient records showing if they have an active infection - Patient records showing if the patient had clinical relapses of MS - Hepatitis B virus screening results (if this is the first dose

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