November 8, 2021
Qutenza (capsaicin 8% topical system) Billing and Coding Instruction Article
Qutenza® is indicated for the management of neuropathic pain associated with post-herpetic neuralgia and diabetic peripheral neuropathy.
Coding for Qutenza
CPT code:
- 64999 Unlisted procedure, nervous system
HCPCS:
- J7336 Capsaicin 8% patch, per 1 square centimeters
ICD-10 codes associate with ICD-10 code aligned with FDA labeled use for this product such as:
- B02.23 - Postherpetic polyneuropathy
- B02.29 - Other postherpetic nervous system involvement (postherpetic radiculopathy)
- E10.40 - Type 1 diabetes mellitus with diabetic neuropathy, unspecified
- E10.41 - Type 1 diabetes mellitus with diabetic mononeuropathy
- E10.42 - Type 1 diabetes mellitus with diabetic polyneuropathy
- E11.40 - Type 2 diabetes mellitus with diabetic neuropathy, unspecified
- E11.41 - Type 2 diabetes mellitus with diabetic mononeuropathy
- E11.42 - Type 2 diabetes mellitus with diabetic polyneuropathy
Unlabeled use of this drug is subject to review on case-by-case basis, and will be required to meet the reasonable and necessary criteria for off-label use as described in the Medicare Benefit Policy Manual Chapter 15, Section 50.4.2, Unlabeled Use of Drug.