Test Catalog Ordering Insurance & Billing Test Results Investigate Variants Register Sign In IntelliTest Manager Contact About Us Insurance & Billing Athena Alliance Program Commercial Insurance Medicare & Medicaid Letters of Medical Necessity Letters of Medical Necessity Many insurance plans require prior authorization in order to perform genetic testing. When a request for prior authorization is made, it’s important to include a letter of medical necessity that explains why Athena’s testing services are needed. Below you will find letters for several of Athena’s commonly ordered tests. Use the letter with your initial request for prior authorization. If the insurance company denies your request, include the appeal letter with your appeal of their denial. Generic Letter of Medical Necessity Letter CNS Autoantibodies Complete Paraneoplastic Evaluation - Test Code 467 Paraneoplastic Neurological Syndromes, Initial Assessment - Test Code 4500 Epilepsy Epilepsy Advanced Sequencing and CNV Evaluation Epilepsy Sub panels Generalized, Absence, Focal, Febrile, and Myoclonic Epilepsies Epileptic Encephalopathy Developmental Brain Malformations Intellectual Disability Neuronal Ceroid Lipofuscinosis Epilepsy with Migraine Syndromic Disorders Infantile Spasms Complete SCN1A Evaluation Peripheral Neuropathy CMT Advanced Evaluation Comprehensive – Test Code 4001 CMT Advanced Evaluation - Initial Genetic Assessment - Test Code 4010 SensoriMotor Neuropathy Profile - Complete - Test Code 287 Ataxia Ataxia, Comprehensive Evaluation - Test Code 6930 Ataxia, Complete Dominant Evaluation - Test Code 6900 Ataxia, Complete Recessive Evaluation - Test Code 6910 Ataxia, Common Repeat Expansion Evaluation - Test Code 6901 Ataxia, Supplemental Recessive Evaluation - Test Code 6911 Hereditary Spastic Paraplegia HSP, Comprehensive Evaluation - Test Code 6630 HSP, Common Sporadic Evaluation - Test Code 6601 HSP, Complete Dominant Evaluation - Test Code 6610 HSP, Common Dominant Evaluation - Test Code 6611 Endocrinology Monogenic Diabetes (MODY) 5-Gene Evaluation - Test Code 885 Nephrology Complete PKD Evaluation - Test Code 761 Athena Diagnostics is a leader in diagnostic testing for neurological diseases and offers innovative tests for Alzheimer's disease, muscular dystrophy and other neuromuscular and developmental disorders. View Full Catalog About Us Accreditations and Licensing Patents Held Careers Copyright © 2021 Athena Diagnostics, Inc. All trademarks and service marks identified by ®, ™ or ℠ symbols or appearing in type form different from that of the surrounding text are marks owned by or licensed to Athena Diagnostics, Inc., its subsidiaries or affiliates, unless otherwise identified as being owned by another entity. See Full Notice Genetic Testing Policies Cookies Notice Privacy Shield Privacy Terms DO NOT SELL MY PERSONAL INFORMATION Language Assistance / Non-Discrimination Notice Asistencia de Idiomas / Aviso de no Discriminación 語言協助 / 不歧視通知 200 Forest Street, 2nd Floor Marlborough, MA 01752 Phone (508) 756-2886 Need Help?