Tirosint Reimbursement Guide

IBSA Pharma Inc. has developed this resource to support healthcare professionals (HCPs) navigate coverage, coding, and insurance coverage for Tirosint® (Levothyroxine sodium) capsules. The information in this Reimbursement Guide is intended solely as a resource to assist the staff in physicians’ offices with certain insurance-related questions for Tirosint®.

Sample Letters of Medical Necessity and Appeal for Insurance Provider

Provided below are downloadable templates to reference and utilize at your convenience for insurance providers on behalf of Tirosint. These are not to be sent as is, fill in patient information as needed since these are not complete letters.

ICD-10 Codes

To see the full list of ICD-10 codes, click the button below

Procedure Notes Forms