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. Antimalarial drugs chloroquine and primaquine Malaria drug hydroxychloroquine In general, a visual field may be done only once every 6 months. Also, some payers will not pay a visual field separately from an eye exam if you. do not have a separate DX code for the eye exam that is not significantly different from the DX code you are using to bill the visual field. If you take Plaquenil for your inflammatory disease, your ophthalmologist will check for damage to the retina in the back of the eye while you take the drug. I was told from the start by my rheumatologist I would have to have eye exams including visual field exams every six months due to the plaquenil therapy. My first two exams did include these tests. But my next six month appointment is coming up, and they told me I didn't need the visual field test this time so the appointment would be shorter. 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. What do you bill a plaquenil eye exam How Do Ophthalmologists Look for Plaquenil Damage? - American., How Do Ophthalmologists Look for Plaquenil Damage? - American Academy. Chloroquine primaquineHydroxychloroquine eyePlaquenil side effects tiredPlaquenil and anesthesiaAnyone has uti from taking hydroxychloroquine Period for problems that have nothing to do with their surgical procedure USED ON E&M CODE •-25 Separately identifiable E&M service done on the same date as a procedure. Used when patient comes in for exam and you end up doing a Procedure e.g. Punctal Plugs or Trichiasis procedure Generally CC is separately identifying USED ON E&M CODE Coding and Billing Update Handout. Plaquenil therapy and eye exams. - Eye Care - MedHelp. Eye screening for patients taking hydroxychloroquine Plaquenil. If you are taking Plaquenil to treat an inflammatory condition or malaria, you should be aware of the side effects that may occur to your eyes and vision. Plaquenil hydroxychloroquine is in a class of drugs called disease-modifying anti-rheumatic drugs, which are used to decrease inflammation, pain and joint damage. Here you can look up any and all diagnosis codes you may need to code the eye exam, as it is critical that you accurately choose the most specific code available for every patient encounter. Another convenient tool for learning billing and coding for optometry is the coding booklet I put together that can be found on Amazon or at 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.