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. Chloroquine side effects treatment Plaquenil eye exam 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 H35.389 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2020 edition of ICD-10-CM H35.389 became effective on October 1, 2019. This is the American ICD-10-CM version of H35.389 - other international versions of ICD-10 H35.389 may differ. New Plaquenil Guidelines - Review of Optometry. Remember, any patient who is at a high risk for Plaquenil toxicity should be examined on an annual basis following the baseline exam. The goal of monitoring/screening is to identify early macular damage prior to irreversible vision loss or even before visible signs of bull’s eye maculopathy. 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 Optic Nerve and Retinal Imaging Methods - Medical Clinical., ICD-10-CM Diagnosis Code H35.389 Toxic maculopathy. How does hydroxychloroquine work 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. Ask the Expert Plaquenil and Sjögren’s. Coding Eye Exam For Plaquenil. Hydroxychloroquine Plaquenil Toxicity and Recommendations.. Documentation for EO should be above and beyond the exam notes pertaining to the retina. A retinal drawing is a necessary component of the documentation. Although policies differ, some charting requirements are common, including the following The documentation must be legible. Retinal drawings must be maintained in the patient’s record. My Take on New Ocular Screening Guidelines for Plaquenil By Sergio Schwartzman, MD. being treated with hydroxychloroquine be seen for formal visual field evaluation once or twice a year to monitor for retinal toxicity. The previous AAO guideline recommended screening every 12 months. the new AAO screening and follow-up recommendations. 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.