Wiki 64640 Qutenza Application

[youngva462@gmail.com]

I work in a private podiatry practice. We've started using Qutenza recently and we have the coding of J7336 down fine. But there is discussion on how to bill 64640 (destruction by neurolytic agent, other peripheral nerve or branch) [granted i thought we should be using 64632 "destruction by neurolytic agent, plantar common digital nerve" but i was overruled by the higher ups]

the debate is do we -
(1) have 64640 on 1 line with multiple units (in our case 2, because we apply to both feet during 1 visit)

(2) have 64640 on 2 separate lines with a laterality modifier

any input would be appreciated

 

[jkyles]

Hi there, both of those codes describe an injection that targets a specific nerve or nerves. From the CPT manual:

Destruction by Neurolytic Agent (eg, Chemical, Thermal, Electrical or Radiofrequency) and Chemodenervation Procedures on the Extracranial Nerves, Peripheral Nerves, and Autonomic Nervous System (Last revised: 2013)

Codes 64600-64681 include the injection of other therapeutic agents (eg, corticosteroids). Do not report diagnostic/therapeutic injections separately. Do not report a code labeled as destruction when using therapies that are not destructive of the target nerve (eg, pulsed radiofrequency), use 64999. For codes labeled as chemodenervation, the supply of the chemodenervation agent is reported separately.

Edit: You'll need to go with an unlisted code such as 64999.

 

[podcoder70]

Qutenza application does not have a code, use the unlisted code. Unspecified CPT code is required to be used, either CPT 64999 or CPT 17999 based upon the desire of the individual Medicare Administrative Carrier

 

[CaroleF01]

Qutenza application does not have a code, use the unlisted code. Unspecified CPT code is required to be used, either CPT 64999 or CPT 17999 based upon the desire of the individual Medicare Administrative Carrier

What comparable CPT code can we use to establish the pricing for the 64999?

 

[podcoder70]

What comparable CPT code can we use to establish the pricing for the 64999?

Ah, great question! I would say 64450