Wiki Qutenza patch

[missyah20]

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.

Thanks!

 

[dwaldman]

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.

2. http://www.cms.gov/McrPartBDrugAvgSalesPrice/

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®."

 

[missyah20]

Thanks!