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Neurology

The most common way a hereditary neuropathy workup goes wrong isn't a missed gene.

It's an unruled-out B12 deficiency. Or an undiagnosed diabetic neuropathy. Or a medication effect nobody connected to the presenting symptoms. Hereditary causes account for a real and often underdiagnosed share of neuropathy and epilepsy cases — but they're not supposed to be the first hypothesis tested. They're supposed to be the one you reach after the reversible and structural causes have been checked and ruled out.

GATES OPEN IN ORDER GATE 1 GATE 2 CLEARED Reversible causes checked first Structural causes checked next Hereditary pathway now appropriate Case
The hereditary pathway is the destination, not the starting point. The case advances only as each gate clears.

Safety gates before genetic gates

ScreenMyGene applies structural- and reversible-cause safety gates before a hereditary neuropathy or epilepsy panel is surfaced. That's not a limitation bolted on for compliance — it reflects how the workup is actually supposed to sequence. A genetic recommendation that skips this step isn't faster, it's just wrong more often, and it puts a specialist-grade panel behind a documentation gap a generalist workflow would have caught.

How it works for neurology specifically

1. Presentation and workup extraction — Documented symptoms, exam findings, and any completed workup are pulled from the chart.

2. Safety gate evaluation — Structural and reversible causes relevant to the presentation are checked against what's documented before a hereditary pathway is considered.

3. Tier-1 evaluator matching — Once safety gates clear, the presentation is matched against Tier-1 gene-disease evaluators for the relevant condition.

4. ICD-10 and coverage check — The recommendation is anchored to a documented, matching diagnosis code and checked against Medicare LCD/NCD coverage policy.

TWO ROUTES, SAME PATIENT Straight to panel Symptoms noted Panel ordered B12 never checked Explains nothing. Denial likely. Gated workup Symptoms noted Reversible causes cleared Panel on solid ground Documented. Defensible.
The same presentation routed two ways. The difference is rarely the panel ordered — it is whether anything was ruled out first.

What this catches that a straight-to-panel approach misses

AFTER GATES CLEAR Hereditary neuropathy Epilepsy Related presentations Matched against Tier-1 gene–disease evaluators, then coverage-checked
Once safety gates clear, the presentation is matched to Tier-1 evaluators for the relevant condition.

Who this is for

See how safety gates shape the recommendation before the panel does.

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New: ENFD workflow for small-fiber neuropathy

The platform now includes a dedicated ENFD module supporting epidermal nerve fiber density evaluation — extending the gated neurology workup into small-fiber neuropathy, where structured documentation and correct test sequencing decide both diagnostic quality and coverage. Combined with structural- and reversible-cause safety gates, the hereditary pathway is reached at the right moment, with a record a payer can follow.

27%denial rate for advanced genetic testing claims — most fail on sequencing and documentation, not clinical merit
ENFDdedicated epidermal nerve fiber density workflow, new in the 2026 release
Tier-1gene–disease evaluators applied only after safety gates clear

Common questions

Why check reversible causes before a hereditary neuropathy panel?

Because B12 deficiency, diabetic neuropathy, and medication effects explain many presentations - and payers expect the standard workup documented before genetic testing. Skipping it invites both misdiagnosis and denial.

What is ENFD testing?

Epidermal nerve fiber density evaluation supports small-fiber neuropathy workups. Structured ENFD documentation strengthens the clinical picture and the medical-necessity record around neurology-related genetic testing decisions.

What does the safety-gated approach change in practice?

The recommendation arrives with the rule-out steps documented, so the genetic order stands on solid ground clinically and survives coverage review.

Denial prevention guidePlatform overviewWhat's new in 2026