Insurance Toolkit
Templates, forms, and resources to help you get insurance coverage or FSA/HSA reimbursement for NeuroDot products
Medical Necessity Letter Templates
Medical Necessity Letter - FOCUS Formula
Watermelon Clarity
Template letter for healthcare providers to establish medical necessity for NeuroDot FOCUS Formula.
Medical Necessity Letter - PROTECT Formula
White Cherry Shield
Template letter for healthcare providers to establish medical necessity for NeuroDot PROTECT Formula.
Medical Necessity Letter - SLEEP Formula
Blue Raspberry Ritual
Template letter for healthcare providers to establish medical necessity for NeuroDot SLEEP Formula.
Medical Necessity Letter - GUT RESET Formula
Lemonade Cleanse
Template letter for healthcare providers to establish medical necessity for NeuroDot GUT RESET Formula.
Insurance Forms & Documents
Prior Authorization Request Form
Standard form for requesting prior authorization from insurance providers
Insurance Appeal Letter Template
Template for appealing insurance claim denials
FSA/HSA Eligibility Documentation
Documentation for Flexible Spending Account and Health Savings Account eligibility
Genetic Testing Coverage Request
Template letter for requesting insurance coverage for genetic testing
Billing Codes Reference
Use these HCPCS and CPT codes when submitting claims for NeuroDot products and related services. The appropriate code will depend on your specific situation and provider recommendations.
| Code | Description | Actions |
|---|---|---|
| S9433 | Medical food nutritional services, administered orally, per diem | |
| 97802 | Medical nutrition therapy; initial assessment and intervention, individual, face-to-face with the patient, each 15 minutes | |
| 97803 | Medical nutrition therapy; re-assessment and intervention, individual, face-to-face with the patient, each 15 minutes | |
| 97804 | Medical nutrition therapy; group (2 or more individual(s)), each 30 minutes | |
| G0270 | Medical nutrition therapy; reassessment and intervention, following second referral in same year for change in diagnosis, medical condition, or treatment regimen | |
| S9470 | Nutritional counseling, dietitian visit | |
| 81225 | CYP2C19 (cytochrome P450, family 2, subfamily C, polypeptide 19) gene analysis, common variants | |
| 81226 | CYP2D6 (cytochrome P450, family 2, subfamily D, polypeptide 6) gene analysis, common variants | |
| 81227 | CYP2C9 (cytochrome P450, family 2, subfamily C, polypeptide 9) gene analysis, common variants | |
| 81291 | MTHFR (methylenetetrahydrofolate reductase) gene analysis, common variants (e.g., C677T, A1298C) | |
| 81232 | DPYD (dihydropyrimidine dehydrogenase) gene analysis, common variants | |
| 81401 | Molecular pathology procedure, Level 2 (e.g., APOE, COMT, HTR2A, MTHFR) | |
| 81479 | Unlisted molecular pathology procedure (for multi-gene panels not otherwise classified) |
Code Categories Explained
Use these codes for dietary consultations and nutritional counseling services provided by qualified healthcare professionals.
Use these codes for genetic testing that evaluates how genes affect drug metabolism and response. Common for CYP450 enzyme testing.
Use these codes for genetic variant analysis including MTHFR testing. Code 81479 is for multi-gene panels not covered by specific codes.
Use this code for specialized nutritional formulas prescribed for specific medical conditions that require dietary management.
Frequently Asked Questions
Are NeuroDot products covered by insurance?
Coverage for NeuroDot products varies by insurance provider and plan. Many insurance plans cover medical foods and nutritional supplements when deemed medically necessary by a healthcare provider. We recommend checking with your specific insurance provider regarding coverage policies.
How do I submit a claim for NeuroDot products?
To submit a claim, you'll need a prescription or letter of medical necessity from your healthcare provider. Submit this along with your receipt and a completed claim form to your insurance provider. Our Insurance Toolkit provides templates and forms to help streamline this process.
Are NeuroDot products eligible for FSA/HSA reimbursement?
Yes, NeuroDot products are generally eligible for reimbursement through Flexible Spending Accounts (FSA) and Health Savings Accounts (HSA) when prescribed by a healthcare provider for a specific medical condition. Our FSA/HSA Eligibility Documentation can be provided to your plan administrator.
What if my insurance claim is denied?
If your claim is denied, you have the right to appeal the decision. Our Insurance Appeal Letter Template can help you craft an effective appeal. Many denials are overturned upon appeal, especially when additional documentation of medical necessity is provided.