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 and weight loss Sarcoidosis treatment hydroxychloroquine 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? Thank you. confused Rheumatoid Arthritis. The action of hydroxychloroquine is cumulative and may require weeks to months to achieve the maximum therapeutic effect see CLINICAL PHARMACOLOGY. Initial adult dosage 400 mg to 600 mg 310 to 465 mg base daily, administered as a single daily dose or in two divided doses. In a small percentage of patients, side effects may require temporary reduction of the initial. May 15, 2017 Then have the patient back the next day to obtain the macular OCT without an office visit. Be sure to complete an interpretation and report for each test once it is completed. For a deeper understanding of when to use ABNs, or you want an in-depth look at when to when-not-to use modifiers, check out EyeCode Billing and Coding. 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 Retinal Physician - Hydroxychloroquine Maculopathy An Update., Plaquenil Dosage Guide - Chloroquine target cycleDoses of hydroxychloroquineTylenol plaquenil Clinical evidence has shown that long-term use of chloroquine CQ and/or hydroxychloroquine HCQ can lead to irreversible retinal toxicity. Therefore, these two medications are deemed high risk, and scanning optical coherence tomography may be indicated to provide a baseline prior to starting the medication and as an annual follow-up. CPT code 92133, 92134 - SCODI Medicare Payment.. Can I Bill Fundus Photography and Retinal OCT on the Same Day?. New Plaquenil Guidelines -. Reader Question Coding for Plaquenil Toxicity Observation; Ophthalmology Coding Alert. Reader Question Coding for Plaquenil Toxicity Observation. Published on Wed Sep 01, 1999 "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. Nov 18, 2011 To analyze Humphrey visual field HVF findings in hydroxychloroquine HCQ retinal tests were interpreted retrospectively in this observational case series of 15 patients with HCQ toxicity. Patients seen at Lahey Clinic were identified by. 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?