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. Chloroquine amine Plaquenil and valley fever What plaquenil used for Plaquenil saliva Macular degeneration is diagnosed by an eye test. While Medicare doesn’t cover routine vision exams, beneficiaries may be covered for certain preventive and diagnostic exams to treat eye conditions. If you think you may have macular degeneration, check with your doctor. Medicare may cover an exam to diagnose macular degeneration. Eye code 92012. Most non-Medicare payers have higher allowables for E&M codes. In this example, our commercial payer allowable is higher for the E&M code than the Eye code, so you would bill 99213. Diagnosis Can Affect Code. Have staff clearly indicate in the documentation why the patient presented for the examination; this can affect code. A 26-year-old black female presented in office for her annual comprehensive eye exam. Her medical history was significant for Plaquenil therapy spanning 12 years with a daily dose of 200mg twice daily. She presented with a best-corrected visual acuity of 20/20 OD and 20/20 OS. All preliminary testing revealed normal findings. 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). Medicare allowable ocular testing for chloroquine therapy Chloroquine - FDA prescribing information, side effects and uses, E&M or Eye Code Which to Choose? - American Academy of. Plaquenil cost at costcoPlaquenil corneal depositsWhat are similar drugs to plaquenil Test, and canalith repositioning procedures; thus, laboratory-based vestibular function testing does not add diagnostic information in such routine cases. The evidence is sufficient to determine that the technology is unlikely to improve the net health outcome. Vestibular Function Testing - Blue Cross Blue Shield of.. How to Succeed in Plaquenil Screenings. Billing and Coding Guidelines for Allergy Testing.. 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 Glaucoma is a leading cause of blindness, and a disease for which treatment methods clearly are available and in common use. Glaucoma also is diagnostically challenging. Almost 50% of glaucoma cases remain undetected. Elevated intraocular pressure is a clear risk factor for glaucoma. While this is an exciting development in ophthalmologic care, current mfERG use is not widespread and its future role in hydroxychloroquine retinopathy screening is not fully understood. It seems unlikely that mfERG will replace visual field testing, and adding mfERG to screening protocols may result in greater overall costs.