Avonex 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.

Last verified: May 11, 2026

Blue Cross Blue Shield of Arkansas - Pharmacy Prior Authorization Form Arkansas Blue Cross Blue Shield · Updated May 11, 2026
Blue Cross of Idaho - General Prior Authorization Form Blue Cross of Idaho Health Services, Inc. · Updated May 11, 2026
California - Uniform Prior Authorization FormCalifornia · Updated Apr 16, 2026
CDPHP - General Prior Authorization FormCapital District Physicians Health Plan, Inc. · Updated May 11, 2026
Cigna - General Medication Prior Authorization FormCigna Corporation · Updated May 11, 2026
Cigna - Multiple Sclerosis Drugs Prior Authorization Form Cigna Corporation · Updated Apr 16, 2026

ICD-10 codes for Avonex Prior Authorizations

G35.90Multiple sclerosis, unspecified
G35.10Relapsing remitting multiple sclerosis
G35.20Secondary progressive multiple sclerosis
G35.30Relapsing remitting-progressive multiple sclerosis

Brand Resources

Reimbursement Information Reimbursement Information resource

Support for Getting Your Patient on Avonex

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Avonex (interferon beta-1a) Prior Authorization Forms & ICD-10 Codes | PrescriberPoint