She suffered from Sjogren syndrome and inflammatory arthritis and was currently treated with prednisone and methotrexate. She was previously treated with hydroxychloroquine (Plaquenil) 200mg bid (6.5mg/kg) for 10 years, which was stopped one year prior to presentation. Plaquenil missed period Plaquenil vs methotrexate Local Coverage Article Intraocular Bevacizumab Billing and Coding Guidelines A53008 Links in PDF documents are not guaranteed to work. To follow a web link, please use the MCD Website. Question How should we code exams for patients on high-risk medications in ICD-10? Answer When the doctor finds no pathology, code the systemic disease, such as L93.0 Lupus or M06.09 Rheumatoid arthritis. ICD-10's Z79.899 Other long term current drug therapy should be linked to any tests performed. Aug 30, 2011 Diagnosis Hydroxychloroquine-induced retinal toxicity Discussion. Chloroquine CQ and hydroxychloroquine Plaquenil HCQ have been used for many years, initially for the treatment of malaria but now more commonly for the treatment of inflammatory diseases such as rheumatoid arthritis and lupus 1. Review of systems: Blurred vision, halos, dry eye, dry mouth, gastroesophageal reflux, joint pain Pupils: Reactive to light in each eye from 5 mm in the dark to 2 mm in the light. Extraocular movements: Full, both eyes (OU) Confrontation visual fields: Full OU Intra-ocular pressure The optic nerves appeared healthy with a 0.3 cup-to-disc ratio. Past Ocular History: None Medical History: Sjogren syndrome and inflammatory arthritis, supraventricular tachycardia, anxiety, depression, peptic ulcer disease Medications: prednisone, methotrexate, amitriptyline, ranitidine, estradiol, tizanidine, diltiazem, Restasis Allergies: codeine, droperidol Family History: heart disease, arthritis, cancer Social History: occasional alcohol but no tobacco or intravenous drug use. How to bill for following plaquenil retina icd-10 Deploy V Codes for Victorious Plaquenil Exam Coding., Coding exams for patients on high-risk medications. Can you gain weight on plaquenilHydroxychloroquine treatment for lyme diseaseChloroquine mechanism of drug action and resistance in plasmodium falciparum Since the initial screening and monitoring recommendations were published in 2002, there have been reports of retinal toxicity associated with the use of Plaquenil. Furthermore, the advent of novice sensitive diagnostic modalities has led to a revision of the recommended guidelines for patients using Plaquenil see “2011 Plaquenil Screening. New Plaquenil Guidelines. Hydroxychloroquine Plaquenil Toxicity and Recommendations.. Retinal Physician - CODING Q&A Extended Ophthalmoscopy.. 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 medication diagnosis as the primary diagnosis since that is the reason for the testing. In summary, if you have Sjögren’s, hydroxychloroquine may be an option to help your symptoms. Because there are other more effective therapies available to treat dry eyes and dry mouth, it is typically prescribed to help musculoskeletal pain and fatigue. Be patient, as the drug may take up to 6 months to see a beneficial effect. P atients taking Plaquenil hydroxychloroquine, Sanofi-Aventis on a long-term basis may leave you scratching your head when it comes to coding the patient encounters. Although coding for long-term medications is not a difficult process, it often involves communicating with other physicians or specialists to obtain accurate information.