“We have a provider who wants to do Qutenza patches for neuropathy affecting a patient’s foot. The vendor suggested CPT code 64632. I cannot find anything official to support that code and most of the carriers that do have policies state that there is no CPT code for the application and to list the J code for the medication. Do you have any insight here or anything official that states that CPT code 64632 would be appropriate?”
Because Qutenza must be applied by a healthcare professional in a clinic due to its high strength and safety monitoring, it is typically billed under Medicare Part B as an in-office medical procedure rather than a standard retail prescription under Part D.
Most private insurance providers cover the patch and its in-office application, though prior authorization by the doctor is frequently required.
CPT code 64632 is defined as the following: Destruction by neurolytic agent; plantar common digital nerve. This is not the correct CPT code to use for the application of a Qutenza patch to the foot.
It is my opinion that the best way to proceed would be to contact the specific healthcare contractor whether it is Medicare, a Medicare Advantage Plan, or a commercial health insurance company and try to obtain in writing how they prefer the service to be billed.
Possible Options:
Using Unlisted CPT Codes: This is my preference based upon health insurance contractors. (MGW, DPM, CPC)
Example #1: 64999 (Unlisted procedure, nervous system).
Logic: Several standard Medicare MAC guidelines (such as CGS Medicare) explicitly direct providers to bill the application procedure under CPT 64999. While unlisted codes accurately reflect that no specific code exists, they typically trigger manual reviews and require the provider to submit detailed clinical notes.
Example #2: 17999 (Unlisted procedure, skin, mucous membrane and subcutaneous tissue.
Evaluation and Management (E/M) Codes: This is not my preference (MGW, DPM, CPC)
Some payers prefer that the provider bills a standard office visit code (such as 99213 or 99214) to account for the doctor's time evaluating the patient, managing medication, and monitoring vital signs during the 30-minute foot application.
Regardless of which application procedure code is preferred by the insurance company, the patch itself must be billed separately using the specific HCPCS supply code:
HCPCS Code J7336: Capsaicin 8% patch, per 1 square centimeter. Providers must map out the exact dimensions of the feet treated and calculate the total number of square centimeters utilized.
This is my opinion.
Michael G. Warshaw, DPM, CPC
THE 2026 PODIATRY CODING MANUAL IS NOW AVAILABLE in either Book or Flash-drive formats. It has been completely updated for the calendar year 2026. Many offices across the country consider this to be their “Bible” when it comes to coding, billing, and documentation. The price is still only 125.00 including shipping! To
purchase, access the website drmikethecoder.com.
No credit card? No problem! Just send a check for 125.00 to the following address:
Dr. Michael G. Warshaw
2027 Bayside Avenue
Mount Dora, Florida 32757
Read Comments