Aubagio Prior Authorization Resources

Find the right PA form for your patient's payer, get the ICD-10 codes you need, and download appeal templates — all in one place.

AmeriHealth Caritas New Hampshire - Prior Authorization Request FormAmeriHealth Caritas New Hampshire
Blue Cross Blue Shield of Arkansas - Pharmacy Prior Authorization Form Arkansas Blue Cross Blue Shield
Blue Cross of Idaho - General Prior Authorization Form Blue Cross of Idaho Health Services, Inc.
Blue Shield of California - Treatment Authorization Request for Medi-Cal MembersBlue Shield of California
Boeing - Boeing Multiple Sclerosis Prior AuthorizationBoeing
Boeing - Boeing Healthcare Administered Multiple Sclerosis Prior AuthorizationBoeing

ICD-10 codes for Aubagio Prior Authorizations

G35.41Secondary progressive multiple sclerosis

Appeal Templates

If the payer denies coverage, these templates help you build a stronger appeal.
Coverage Authorization AppealsCoverage Authorization Appeals resource
Letter of Medical Necessity Letter of Medical Necessity resource
A peer-to-peer review with the payer's medical director can often resolve denials faster than a formal appeal.

Support for Getting Your Patient on Aubagio