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 eye toxicity Plaquenil substitute A documented disorder of the optic nerve, the neurologic visual pathway, or retina. Patients with a previously diagnosed retinal detachment do not need a pretreatment visual field examination. Additionally, patients with an established diagnosed cataract do not need a follow-up visual field unless other presenting symptomatology is documented. Hydroxychloroquine Plaquenil is considered a disease-modifying anti-rheumatic drug DMARD. It can decrease the pain and swelling of arthritis. It may prevent joint damage and reduce the risk of long-term disability. Hydroxychloroquine is in a class of medications that was first used to prevent and treat malaria. 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 1is now considered for new disease applications in diabetes, heart disease and adjunct. 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 CPT code 92133, 92134 - SCODI Medicare Payment., Hydroxychloroquine Plaquenil Too much hydroxychloroquineDengue chloroquineWhat happens if you take too much hydroxychloroquinePlaquenil and alcohol After the surgery, the blind area was more noticeable because my sight in that eye was so much clearer,” she says. “The surgeon sent me to a retina specialist, who recommended that I cut down my dose of Plaquenil. Finally, my rheumatologist recommended that I stop taking the drug altogether.” Protecting your eyesight when taking Plaquenil Lupus Foundation of.. Hydroxychloroquine Plaquenil Toxicity and.. Plaquenil Side Effects on Your Eyes and Vision. CODING & BILLING UPDATE SOUTHEAST EYE SPECIALISTS, PLLC. •One of the following 7th characters is to be assigned. Plaquenil change on 10/1/2016 Sep 13, 2019 Only eye doctors can use the 92xxx codes and they can be used for both medical and routine exams. The 99xxx medical billing codes are utilized by all health care professionals and are specific to medical-only exams with further guidelines you must follow. 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.