Q: What is visual field testing with the Humphrey® Field Analyzer (HFA™)? A: The term “visual fields” encompasses a variety of subjective tests to determine a patient’s scope of vision, both central and peripheral. The National Coverage Determination for computer enhanced perimetry, NCD 80.9, states that “Computer enhanced perimetry involves the use of a micro-computer to measure visual sensitivity at pre-selected locations in the visual field. Hydroxychloroquine monitoring ophthalmology Can you break plaquenil in half Side effects of plaquenil and methotrexate Plaquenil mechanism of action 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. The three most-common ICD-9 codes used for patients on high-risk medications such as plaquenil include The code for the condition e.g. 714.0, rheumatoid arthritis with Plaquenil, V58.69 long-term use of high-risk medications, and; The E-code for the medication E931.4 for Plaquenil. In addition to the optometry CPT codes for office visits, there are also procedure codes you must familiarize yourself with, such as bilateral procedures 92250 Fundus Photos and 92083 Threshold Visual Fields. Bilateral procedures have one fee associated with them whether you perform the procedure on one or both eyes. Q: Does NCD 80.9 supersede information in the local policy if my MAC publishes a more detailed policy? The introduction to the NCD manual states “Where coverage of an item or service is provided for specified indications or circumstances but is not explicitly excluded for others, or where the item or service is not mentioned at all in the CMS Manual System the Medicare contractor is to make the coverage decision, in consultation with its medical staff, and with CMS when appropriate, based on the law, reg-ulations, rulings and general program instructions”. This includes confrontational visual field testing, static perimetry and kinetic perimetry. It is a covered service when used in assessing visual fields in patients with glaucoma or other neuro-pathologic defects.” Most Medicare Administrative Contractors (MACs) also publish local coverage determination (LCD) policies that supplement the NCD; check your local policies. How to bill for plaquenil visual field Protecting your eyesight when taking Plaquenil Lupus., How to pick the right benefit notice and bill for medications Plaquenil help lower back painWhy does chloroquine itchPlaquenil 200 mg film-coated tablets Arizona Subscriber Answer Plaquenil is the trade name for hydroxy-chloroquine, a medication used to treat rheumatoid arthritis and lupus. It can harm the lens and retina of the eye. Primary-care physicians often refer a patient to an ophthalmologist for monitoring ocular changes. Reader Question Use V Codes for Plaquenil Patients.. The Ultimate Guide to Optometry Billing and Coding.. Ophthalmic Professional - Coding. Although hydroxychloroquine retinal toxicity is thought to be rare, recent studies suggest it may have a higher prevalence than previously recognized. A large study examining patients with more than 5 years of HCQ use were evaluated with 10-2 visual fields or spectral-domain optical coherence tomography SD OCT. A 45-year-old black female presented with no ocular or visual complaints. Her ocular history was unremarkable. However, her medical history was significant for a recent diagnosis of lupus. Her rheumatologist instructed her to undergo a baseline ocular examination prior to initiating Plaquenil hydroxychloroquine, Sanofi-Aventis therapy. The patient has a disorder of the eyelids potentially affecting the visual fields. 2. The patient has a visual field defect detected on gross visual field testing e.g. confrontational testing. 3. The patient has a documented diagnosis of glaucoma. It should be noted that the progression of, and effects of treatment on glaucoma can be monitored only through periodic visual field testing.