Medicare allowable ocular testing for chloroquine therapy

Discussion in 'Canadian Pharmacy' started by imtoy, 20-Mar-2020.

  1. Neir0mancer Guest

    Medicare allowable ocular testing for chloroquine therapy

    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.

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    Ophthalmologic Considerations and Testing in Patients Receiving Long-Term Antimalarial Therapy HOWARD N. BERNSTEIN, M. D. Bethesda, Maryland From the Sub-Section of Ophthalmology, Subur- ban Hospital, Bethesda, Maryland, and the Oph- thalmology Department, Washington Hospital Center, Washington, D. C. Requests for reprints should be addressed to Dr. Howard N. Bernstein, 11404 Old Georgetown Road. A maximum of 10 doses per vial is allowed for Medicare billing, even if more than ten preparations are obtained from the vial. In cases where a multidose vial is diluted, Medicare should not be billed for diluted preparations in excess of the 10 doses per vial allowed under code 95165. 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.

    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

    Macular degeneration tests & treatment -, Billing and Coding Guidelines for Allergy Testing.

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  5. 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.

    • E&M or Eye Code Which to Choose? - American Academy of..
    • CPT code 92133, 92134 - SCODI Medicare Payment..
    • Ocular complications of chloroquine and derivatives therapy..

    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. These annual examinations should include a thorough ocular exam, automated 10-2 visual fields, and 1 or more of the recommended objective tests. Visual field testing and objective tests are able to detect retinal changes before damage can be seen via fundus photography or dilated fundus exams. 5-7 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.

  6. Guest

    Hi there, I normally post on the arthritis board, and due to toxicity of the Plaquenil after 2 years, I have had to discontinue it, since I failed the visual field testing. I'm sure you do feel like you're losing your mind.(((hugs)))Pat Hi there, I had put a posting about this a few weeks ago on here. Plaquenil Hydroxychloroquine - Side Effects, Dosage. Discontinued Plaquenil.other options? Plaquenil side effects - kidney problems? - Symptoms - Life.
  7. Tanya_D XenForo Moderator

    La infección por micoplasma es una enfermedad respiratoria ocasionada por el Mycoplasma pneumoniae, un organismo microscópico relacionado con las bacterias. LUPUS - RHEUMATIC Stevens-Johnson Syndrome - Cleveland Clinic Is Early, Aggressive Treatment Best for All Rheumatoid.
  8. webinvestor Guest

    Buying Prescription Drugs In Mexico - People's Guide Diabetic test supplies are scarce and very expensive. Disease modifying drugs for arthritis such as Plaquenil and gold salts are not common. • How do I know if my medication is “controlled” or not? Ask your physician or pharmacist. • Can I use a valid prescription written by my U. S. or Canadian doctor to buy controlled medications in.

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  9. kirakl Well-Known Member

    Chloroquine - Wikipedia Chloroquine enters the red blood cell by simple diffusion, inhibiting the parasite cell and digestive vacuole. Chloroquine then becomes protonated to CQ2+, as the digestive vacuole is known to be acidic pH 4.7; chloroquine then cannot leave by diffusion.

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