Reimbursement

Reimbursement has never been easier.


Introducing the Solesta Reimbursement Assistance Program 

Solesta Reimbursement Assistance Program Benefits

  • Designed to create an easier reimbursement experience for your practice

  • Developed to help your office save time and energy while keeping you informed every step of the way

Privately Insured Patients

  • Handles communications with you patient's private insurance pharmacy benefit

  • Once approved, Solesta will be shipped directly to your office

  • Your practice assumes no financial risk for product acquisition
 

Seeking reimbursement for any product can be a time-consuming process for you and your office staff. When it comes to product reimbursement for Solesta, we’re here to help.

Simply fill out the Service Request Form - for our expert assistance.

The Solesta Reimbursement Assistance Program minimizes barriers that delay or prevent access to Solesta and provides personalized reimbursement support to you and your patients. Call 1-877-546-7150 or email solestareimbursement@palettelifesciences.com for more information.

Important 2020 CPT Code Updates


Coding and Billing Instructions for CMS Form 1500

Effective January 1, 2020

Deleted CPT Code: 0377T

  • Anoscopy with directed submucosal injection of bulking agent for fecal incontinence, using products such as NASHA/Dx (Solesta)


As of January 1, use CPT Code 46999

  • Unlisted procedure, anus
  • CPT code 46999 is a Category 1, permanent code, used for multiple miscellaneous/unlisted procedures


The HCPCS code for Solesta remains the same:
HCPCS Code: L8605

  • Injectable bulking agent, dextranomer, hyaluronic acid copolymer implant, anal canal, 1 ml

Example of Medicare Local Coverage Determination (LCD) for Solesta

The remaining 11 Medicare carriers have not yet published formal LCDs, but they are providing coverage for Solesta on a case-by-case basis, with the written policy at the link above serving as a strong precedent for coverage of use of the product within the FDA-Approved Indications for Use (IFU).   

Example of Private Payer Coverage Policies for Solesta

The Solesta Reimbursement Assistance Program is actively tracking coverage polices for other private payers and has been very successful in securing coverage on a patient-specific bases. 

For further information, please contact the Solesta Reimbursement Assistance Program:

Phone: 1-877-546-7150

Email: solestareimbursement@palettelifesciences.com 


Or request a visit from a Solesta Sales Representative