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. Is there withdrawal from hydroxychloroquine Chloroquine hydrochloride tablets Plaquenil side effects eye pain 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. The risk of plaquenil-induced toxic maculopathy is associated with a cumulative dose level of 1,000 grams and it usually takes 5-7 years for patients on the standard dose of 250-400 milligrams per day to reach that level. 2 Based on a dose of 200 milligrams per day for the past twenty years. The study findings revealed that when hydroxychloroquine was used at doses 5mg /kg, the risk of retinopathy was 1% in the first 5 yrs. 2% in 10 yrs. 20 % after 20 yrs. There was a dose response, such that those receiving doses greater that 5 mg / kg had the greatest risk of retinal toxicity. 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). Plaquenil eye icd 10 H35.381-383 Toxic Maculopathy Of Retina - Decision-Maker PLUS, Plaquenil-Induced Toxic Maculopathy - Decision-Maker PLUS Chloroquine buy on lineHydroxychloroquine hyperpigmentationPlaquenil methotrexate shigles vaccineChloroquine injection route Background The American Academy of Ophthalmology recommendations on screening for chloroquine CQ and hydroxychloroquine HCQ retinopathy are revised in light of new information about the prevalence of toxicity, risk factors, fundus distribution, and effectiveness of screening tools. Recommendations on Screening for Chloroquine and.. My Take on New Ocular Screening Guidelines for Plaquenil.. The Ultimate Guide to Optometry Billing and Coding.. 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. Aug 15, 2017 The ICD-10 section that covers long-term drug therapy is Z79, with many subsections and specific diagnosis codes. Because Plaquenil does not have its own specific category, clinicians should use Z79.899—Other Long Term Current Drug Therapy. Plaquenil hydroxychloroquine Screening, ICD-10 Z79.889. Patient Name Date of Birth Doctor Clinic High Risk Factors Asian ethnicity Tamoxifen use Macular disease AMD, ERM, etc. Kidney renal or Liver hepatic disease. Note for Plaquenil Doctor Patient Handout.