Wiki Long term (current) use of hydroxychloroquine (Plaquenil)

[jpeterson015]

We've started to get denials on our visual fields (92083) and macular OCT (92134) tests when the provider is performing them for the long term (current) use of hydroxychloroquine (Plaquenil). Can someone tell me what ICD-10 code you're using when billing?

Thank you,
Jodi Peterson, CPC, OCS

 

[Omy13]

Why was Plaquenil prescribed?

 

[jpeterson015]

Why was Plaquenil prescribed?

The patients are usually on Plaquenil for rheumatoid arthritis and we're checking for Plaquenil toxicity for long term use.

 

[Cheezum51]

Be sure that you list the ICD code for the RA first and then the code for long term use of Plaquenil second. If you don't list them in that order, insurers will often deny payment.

Tom Cheezum, OD, CPC, COPC

 

[Edmundo]

Hi Jodi,

It's a pleasure! If the patient is coming in for drug monitoring, use ICD10CM Z51.81 as your primary for the E/M & Z79.899 (reporting hydroxychloroquine) as your secondary. Please also code the RA in your E/M. As for diagnostics, set Z79.899 as your primary to help support medical necessity. If there's a denial, please request to appeal with medical records.

Kindly,

Edmundo Gonzalez, CPC, COPC, OCS