Most importantly, you help support continued development of this site. The majority of cases of retinotoxicity have occurred in patients that have had a cumulative dose exceeding 1000g of hydroxychloriquine (Plaquenil). This level is reached in about 7 years with the most common daily dose of Plaquenil, 400 mg/day (200 bid). Plaquenil and kidneys Chloroquine sugar cravings Can plaquenill build up and cause migraines Likely to occur in individuals taking high doses for many years, in individuals 60 years or older, or in those with significant kidney disease. At the recommended dose, development of visual problems due to the medication within the first year of use, then repeat every 1 to 5 years based on current guidelines. Hydroxychloroquine Plaquenil 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. But getting the right code is just one step in the process of correctly documenting the encounter. I work in an ophthalmology office. Plaquenil is often prescribed to our pt's for arthritis, which can affect the field of vision. When I send the claim billed as 92083 HVF with the Dx Z79.899 High risk meds, if often comes back denied. Any suggestions on how to get the HVF covered with use. It now solely uses real body weight (rather than ideal body weight) based on new recommendations from a 2014 study (1). Disclaimer: This tool is designed to help eye care professionals better understand the risk the of retinotoxicity from hydroxychloroquine. Please note: This calculator was modified in 9/2015. High risk medication use plaquenil Taking Plaquenil for Rheumatoid Arthritis, Coding Long-term Medications Hydroxychloroquine plaquenil couponsChloroquine autophagy neurons How to use Plaquenil. Use this medication regularly in order to get the most benefit from it. If you are taking it on a daily schedule, take it at the same time each day. This risk may. Plaquenil Oral Uses, Side Effects, Interactions.. Visual Fields and Plaquenil Medical Billing and Coding.. High Risk Medications - Primary Eye Care. Monitoring blood values of Plaquenil is already an important intervention to help track and improve a patient’s medication adherence, and these findings suggest a blood test may also help to reduce overdosage, or flag patients at high risk. Learn about protecting your eyesight when taking Plaquenil. Read the study Baseline data may also uncover high-risk patients. A sharp increase in the prevalence of retinal toxicity is noted following five to seven years of medication use. 6 Newer literature emphasizes the risk of cumulative dosing that occurs over a period of time 1,000g rather than the previous suggestion of 6.5mg/kg of body weight. Thus, annual. Several risk factors may increase the likelihood of retinal toxicity from Plaquenil such as, age of greater than 60 years, daily dose more than 6.5 mg/kg; use of the drug more than 5 years, obesity, preexisting retinal disease and, renal or liver failure.