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This is because steroid injections can make health issues worse

Frontiers in Cellular Neuroscience 9: 298

However, in a subanalysis of participants with low vitamin B 12 status at baseline (n= 101), the B-vitamin supplementation slowed the decline in bone mineral density (total hip and femoral neck but not lumbar spine) (116)

Separate reporting from office visit : If done during an E/M visit (e.g., 99213), Modifier 25 may be required on the E/M code to indicate the injection is a separately identifiable service

Current attempts such as the CobaSorb Test and tests employing a detectable non-radioactive form of B12 may prove to be reasonable alternatives for the original Schillings Test, and thereby help to solve the most important question: Will this patient need a lifelong treatment with pharmacological doses of B12