Qutenza® (capsaicin 8% patch)

No prior authorization required for:

  • Emergency room
  • Inpatient
  • Skilled nursing facility

For further information, please see the Injectable Drugs page

Code(s): J7335

Benefit: Medical

Notes:

Diagnosis of post-herpetic neuralgia

Prior use of all of the following:

  • Gabapentin
  • Lyrica (requires step therapy with gabapentin)
  • Generic tricyclic antidepressant (TCA)
  • oxycodone CR or morphine CR Lidoderm Patch (requires prior authorization)