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Because ICD-10 indicates this is a principal diagnosis, you will always list it first when the reconstruction is performed as a follow-up to a prior medical procedure

Liu J, Wang L, Zhang A, Di W, Zhang X, Wu L, et al

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N Engl J Med 334(22):14481460 Topal G, Brunet A, Millanvoye E, Boucher J, Rendu F, Devynck M, David-Dufilho M (2004) Homocysteine induces oxidative stress by uncoupling of NO synthase activity through reduction of tetrahydrobiopterin

Its important to remember that while vitamin b12 and heart palpitations are linked, other conditions can cause these exact same feelings