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Qutenza patch

  1. #1
    Question Qutenza patch
    Medical Coding Books
    Good Morning,
    Has anyone out there billed for Qutenza patch administration. I found that we have to bill with code 64999, but I do not know what the charge should be for the administration of the patch.

    Missy Heuer CPC, CIRCC, CANPC

  2. #2
    1. Although I don't know if they state this is the forum disclaimer, I have seen it stated that in a coding forum, other forum members can not suggest how much to charge for another list members chargemaster/fee schedule amount, it can be considered price fixing.


    In the above link Medicare pricing can be found

    J7335 Capsaicin 8% patch 10 SQ CM 25.554

    If you are billing 28 units to represent 280 Sq cm (20cm x 14cm) for placement of a whole patch, you can look at the reimbursement and use internal methods to determine appropriate chargemaster/fee schedule amount from there.

    Below is an example of a Medicare carrier stating 64999 is appropriate reporting; whereas, I had also seen on an internet search another Medicare carrier stating it is included in the EM

    "Reporting a separate service for application of Qutenza® is permitted. Such a service must be reported with NOC code 64999. No other neurologic or drug administration service code is appropriate for reporting application of Qutenza®."

  3. #3
    Missy Heuer CPC, CIRCC, CANPC

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