My B 12 level last month was 888. My EMG done at about the same time was barely abnormal. That is the reason that my neuro suggested the skin biopsy. He said that my symptoms were disproportionate to the findings of the EMG so that is why he recommended the skin biopsy. He was quite certain I had small fiber neuropathy and felt comfortable diagnosing me as having that without the skin biopsy. He did feel that down the road having laboratory confirmation would be helpful in my dealings with other medical and insurance establishments. I am insured by a large bureaucracy not known for continuity of care.