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Billing for Qutenza Administration (REVISED)

Qutenza is topical high concentration (8%) capsaicin which is administered by a physician. The FDA approved this treatment for neuropathic pain associated with PHN in 2009 and for neuropathic pain associated with DPN of the feet in 2020. 

Capsaicin’s hypothetical mechanism of action is that the chemical causes a functional neural desensitization with a transient alteration in peripheral nerve fiber function via the TRPV1 receptor channel which is a ligand-gated cation channel selectively expressed on the small diameter sensory neurons polymodal nociceptive nerve fibers, mainly the C and A delta fibers, but does not target a specific nerve. Following the application of the medication, there is a temporary localized decline in both intraepidermal nerve fiber density and sensory nerve sensation. The nerve fiber density improves and normalizes in 12-weeks and returns to baseline within 24-weeks after the capsaicin treatment. There is no destruction of the nerve with the capsaicin despite the localized “regression” of the nociceptive nerve terminals distal to the nerve cell bodies.

The treatment for PHN is performed by applying up to four Qutenza patches for 60 minutes. The treatment for DPN is to apply up to four Qutenza patches for 30 minutes on the feet. The Qutenza treatment can be repeated, but not more frequently than every three months.

There are currently no CPT codes specific to an administration of Qutenza. Therefore, National Government Services recommends that providers use CPT code 17999 (Unlisted procedure, skin, mucous membrane and subcutaneous tissue) during the administration of Qutenza. The reimbursement will analog to CPT code 17360.

Revised 9/7/2022