Her rheumatologist instructed her to undergo a baseline ocular examination prior to initiating Plaquenil (hydroxychloroquine, Sanofi-Aventis) therapy. Toxic maculopathy associated with chloroquine use was first documented in the literature five decades ago.1 In the United States, Plaquenil––an analog to chloroquine––is used to treat a variety of conditions, including rheumatoid arthritis, lupus and several distinct inflammatory disorders. Although the incidence of macular toxicity is infrequent with Plaquenil use (at a dosage of 200mg or 400mg q.d.), its visual impact can be devastating. Sle hydroxychloroquine dose Plaquenil and alcohol side effects Coding OCT with Plaquenil. Thread starter tmr1965; Start date Mar 5, 2014; T. tmr1965 Guru. Messages 210 Best answers 0. Mar 5, 2014 #1 When I code the OCT 92134 I know I can't use the vcode by itself. The patient has RA, but when I look at the LCD it doesn't support the 714.0 dx for RA either. Does anyone know how to code this to get it paid? Sep 13, 2019 Submitting the claim may fall on a billing specialist employed directly in your office, or may be outsourced to a trained billing service that is well educated on the specific codes required for optometric claims. Choosing the right service for coding and billing in optometry is critical to ensuring continuous cash flow for your practice. Hydroxychloroquine, sold under the brand name Plaquenil Sanofi-Aventis, is an antimalarial drug that has gained widespread use in treating various autoimmune diseases, including systemic lupus erythematosus and rheumatoid arthritis. 1 By some estimates, more than 150,000 patients are on long-term therapy with this medication in America alone. 2 Retinal toxicity associated with HCQ use is. Initially, central visual acuity may be unaffected, but the patient may notice related paracentral scotomas that often interfere with reading. The associated classic retinal toxicity is described as a bull’s eye maculopathy (ring of depigmented retinal pigment epithelium that spares the foveal area). Billing oct for plaquenil How to Succeed in Plaquenil Screenings, The Ultimate Guide to Optometry Billing and Coding. Interactions between plaquenil and methotrexateMylan hydroxychloroquine ingredientsCan plaquenil cause ptosisWhat happens when yoou stop taking hydroxychloroquine abruptlyHydroxychloroquine skin rash How to pick the right benefit notice and bill for medications. By Walt Whitley, O. D. Jason Miller, O. D. and Charles Brownlow, O. D. AOAExcel TM Medical Records consultants. This month, we review common questions from colleagues across the country. How to pick the right benefit notice and bill for medications. Multimodal Imaging in Plaquenil Toxicity. Humphrey visual field findings in hydroxychloroquine toxicity. Question What is the best way to code for Plaquenil toxicity observation first, if the patient was referred by the family doctor for a baseline exam prior to the start of treatment; second, if the patient returns six months after the start of treatment to assess ocular changes; and, third, if the patient returns six months later and shows adverse ocular changes? To report expanded SD-OCT findings of HCQ retinopathy that may assist the clinician in earlier diagnosis. To characterize structural changes of HCQ retinopathy with SD-OCT after drug cessation. Setting Private practice and academic institution. Patient Population Patients at New England Eye Center and Ophthalmic Consultants of Boston in Boston, MA diagnosed with HCQ retinopathy and followed. Answer When billing Plaquenil examinations, or any other high risk medication exams, it is appropriate to bill the systemic disease or any ocular manifestations as the primary diagnosis since many payers may not reimburse for the high-risk medication diagnosis as a stand-alone diagnosis. Testing services performed should have the high-risk.