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Administration of non FDA approved drug

W

wtnnicole14

Contributor
Messages
13
Location
Jackson, TN
Does anyone have experience with hormone pellet billing? The pellets themselves are not FDA approved yet, they are a compounded drug. The patient chooses to pay for these as self pay. Has anyone had success with billing 11980 for the insertion of the pellets to insurance? Would you bill the office visit and/or 11980 to insurance for menopausal symptoms and only separate the drug as self pay? Or would you bill the insertion as self pay as well for the patient to pay since the drug is not covered at this time? We want to ensure that we are following the proper protocol and the patient will not end up with an unexpected bill. As well as remaining compliant with payors policy. I haven't been able to find a definitive policy but we do intend to reach out to the payors to confirm.
 
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