FAQ:  Salivary Hormone Testing

Who tests salivary hormone levels?
Moundsville Pharmacy currently recommends ZRT Laboratories for salivary hormone testing.  Saliva samples are collected in the home and mailed directly to ZRT Laboratories.  At your request, Moundsville Pharmacy will work with you and your physicians to review your results to make the most appropriate decisions to encourage successful outcomes.

Which hormones should I have tested?
Currently Moundsville Pharmacy recommends that  female patients test Estradiol, Progesterone, Testosterone, DHEA, and AM Cortisol.  If you elect to test less than the five listed above, ZRT will hold your saliva sample for 30 days and additional testing can be performed at your request. 

In addition, patients with multiple cortisol related symptoms may want to consider morning and evening cortisol testing (this requires a two tube test kit). 

How much does saliva testing cost?
Saliva testing is offered to direct pay patients for $30.00 per hormone (a $15.00 discount from retail pricing), therefore an initial test of 5 hormones would be $150.00.  Note:  Moundsville Pharmacy is able to purchase test kits in advance from ZRT creating an additional discount, a FIVE HORMONE Test Kit costs $150.00

Do I need a prescription to complete saliva testing?
A prescription is not required to complete saliva testing.  However, if you are considering billing this testing to your insurance, a prescription from your physician must be submitted with your saliva sample.  The prescription must order “saliva testing” and the hormones to be tested, along with an ICD-9 diagnostic code, a copy of the front & back of your insurance card, and the signed ZRT Insurance Authorization form MUST be included with your sample submission.  Please read the next question...

Will my insurance pay for saliva testing?
Saliva testing is covered by several insurances, but not all insurances and not all policies.  ZRT does bill some insurances directly, and ZRT would need to be contacted directly to see if your insurance would be included.  In the event your insurance company does not cover the entire cost of your test, you are responsible for any remaining balance.  If your insurance does not cover any of the testing, ZRT will bill you directly for the retail price of $45.00 per hormone.  

As a result, it is critical that you contact your insurance company in advance to find out if saliva testing is covered under your policy, if they cover saliva testing through a non-participating provider (ZRT Lab.), and what percentage of saliva testing is covered.  Also, if your insurance is not one that ZRT will bill directly, find out if and how you can manually submit for reimbursement following testing. 

If you are unsure if you insurance will cover saliva testing, patients may want to pay the discounted $25.00 per hormone initially and manually submit for reimbursement following testing.  Remember to obtain a prescription prior to testing if you are planning to submit for reimbursement!

Note:  When contacting your insurance company, they may ask for CPT codes.  
CPT codes are as follows: 

Estradiol 82670
Progesterone 84144
Testosterone 84402
DHEA 82627
Corisol AM 82530

Moundsville Pharmacy's Recommendation on Insurance Billing:  Moundsville Pharmacy recommends that patients take advantage of the discount offered and complete the testing of five hormones for the discounted cost of $125.00.  Following testing, Moundsville Pharmacy can provide a special insurance reimbursement form which will allow you to submit the testing receipt to your insurance.  Just remember, even though the lab does not require a prescription for testing, the insurance will require that you have a prescription and it should be written prior to the date of testing...so if you are planning on submitting for reimbursement, please get a prescription from your doctor in advance.

Assume your insurance is not going to pay for it, but hope that it will...that way you won't be disappointed...

How should my physician write the prescription?
The prescription should be written as "Salivary Hormone Testing"  with a list of the hormones to be tested on the prescription.  It must also provide an ICD-9 Diagnostic Code (Ex. 259.9 Hormone Imbalance).  It should be signed and dated by the physician with a date prior to testing.

Which forms do I need to complete?
In most cases, all you will need to fill out is the patient requisition form (please fill out the appropriate side: male/female) including the symptoms, current hormones, etc. 

Should I stop taking my hormones before testing?
It is not required that patients stop taking their hormones before testing.  Testing allows patients to evaluate dosages and the need for changes in therapy.  However, some synthetic hormones will not be revealed through saliva testing and may alter the results.  If patients are stopping hormones before testing to determine a baseline level, patients need to wait 4-6 weeks before testing.  As a note, patients should not take any hormones or use any facial creams within 12 hours of collecting saliva.

Moundsville Pharmacy's Recommendation on Hormone Use:  Moundsville Pharmacy recommends that in most cases patients should continue their current therapy.  Any hormone usage can be taken into consideration when reviewing the results.  Most patients would not be able and willing to stop current therapy for the necessary 6 weeks.

If you have any questions regarding hormone use and testing, do not hesitate to contact Moundsville Pharmacy...

When do I collect my saliva?
Postmenopausal patients can collect saliva any day during the month.  Pre-menopausal or peri-menopausal patients should collect between days 19-21 of their menstrual cycle (the first day of your period as day one).

Saliva should be collected within the first two hours of awakening.  When you wake up, do not eat, do not drink, do not brush your teeth, do not floss your teeth.  Wash your hands to prevent any contamination. Rinse your mouth out twice with water to clean your mouth, and begin collecting saliva in the tube.  Test tube must be filled between half and three-fourths the way full.  If you are collecting an evening cortisol (requires two tube test kit), collect the second sample at bedtime (no food or drink, exept water within 2-3 hours).

What do I send to ZRT Laboratory?
The saliva sample with name, date, and time on tube and in the plastic bag AND the ZRT requisition form.

When will I get my results?
If you received your test kit from Moundsville Pharmacy, the results will be sent to you along with a copy to Moundsville Pharmacy.  Results should be received within 2-3 weeks from the date mailed.

What do I do with my saliva testing results?
Following saliva testing, you, the patient, your physician, and your compounding pharmacist, can communicate to prepare a responsible recommendation for your hormone replacement needs.  Moundsville Pharmacy does offer individual consults to review your history, symptoms, and hormone levels to prepare a letter of recommendation for your physician. 


BACK TO STEP 2:  Salivary Hormone Testing