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. Plaquenil 500 mg Is plaquenil considered an immunosuppressant When billing for Spectral Domain-Optical Coherence Tomography SD-OCT chloroquine CQ and/or hydroxychloroquine HCQ for retinal toxicity monitoring, place “SD-OCT in box #19 to reflect that this form of Optical Coherence Tomography was use. 6. When billing for services, requested by the beneficiary for denial that are Medicare exclusions Simple Rules for Coding OCT Published on Fri Jun 04, 2004 Knowing the right codes for OCT can save your office $40 per service If you're getting denials for optical coherence tomography OCT retinal imaging procedures, you could be doing one of five things wrong, experts say. 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. 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). Oct for plaquenil icd10 ICD-10-CM Diagnosis Code H35.389 Toxic maculopathy, unspecified eye, Simple Rules for Coding OCT Lucite plaquenilHydroxychloroquine lightening cream 2 walmartChloroquine diphosphate dmemPlaquenil dose based on weight The study was a Kaiser Permanente retrospective case-control study that examined 2361 patients who had used hydroxychloroquine continuously for at least 5 years according to pharmacy records and who were evaluated with visual field testing or spectral-domain optical coherence tomography. My Take on New Ocular Screening Guidelines for Plaquenil.. Correct diagnosis for a Plaquenil exam - American Academy of Ophthalmology. Quick Guide if you missed Part I Tool Box. Determine the cumulative dose of plaquenil taken by the patient 3. Determine if the patient has reached the threshold for increased risk of plaquenil-induced toxic maculopathy 4. Determine if the patient has plaquenil-induced toxic maculopathy. Evaluation with spectral domain OCT testing; Evaluation with a 10-2 threshold visual field examination Hydroxychloroquine HCQ is an anti-malarial medication that has in recent times been utilized as treatment for a variety of autoimmune diseases, such as rheumatoid arthritis and systemic lupus erythematosus, and other inflammatory and dermatologic conditions. Coding & billing update southeast eye specialists, pllc zachary s. mccarty, od [email protected]@zacheyedoc 2017 medicare deductible 2016 medicare deductible monthlydeductible part a hospital $413 $1,316 part b medical $109 avg $183 part c medicare advantage varies part d medicare prescription drug coverage varies varies cpt.