One such commonly used medication for dermatologic and rheumatologic inflammatory conditions is hydroxychloroquine (Plaquenil), a chloroquine derivative. It is used to treat many diseases including malaria, rheumatoid arthritis and systemic lupus erythematosus. Toxicity of chloroquine Plaquenil and etoh Assessment, diagnosis e.g. Plaquenil macula toxicity OU; no prior hx of color vision defects Impact on treatment, prognosis e.g. Recom-mend discontinuing Plaquenil, letter to Rheumatology Physician’s signature e.g. I. C. Better, MD Q What does Medicare allow for extended color vision testing? A CPT 92283 is per patient, not per eye. Nov 18, 2011 Keywords hydroxychloroquine toxicity, Plaquenil, toxic maculopathy, Humphrey visual field, retinal toxicity, automated perimetry Introduction Misinterpretation of Humphrey visual field HVF findings in patients utilizing hydroxychloroquine HCQ can lead to delay in diagnosis of retinal toxicity. Our office has been including a second diagnosis for the disease related to Plaquenil use. We aren't seeing denials using that method but from a coding standpoint I don't know if that is a 'more correct' coding or if we are just billing different insurances and getting different responses regardless of our using a second dx code. It is imperative that patients and physicians are aware of and watch for this drug’s ocular side effects. Retinal toxicity from hydroxychloroquine is rare, but even if the medication is discontinued, vision loss may be irreversible and may continue to progress. Color dx test in plaquenil toxicity Hydroxychloroquine-Induced Retinal Toxicity - American., Humphrey visual field findings in hydroxychloroquine toxicity Aao plaquenil guidelinesCbd and hydroxychloroquine Although it is considered rare, retinal toxicity from the intake of Plaquenil can be irreversible even if the drug is discontinued 2, 3. What is Plaquenil Toxicity? The toxicity resulting from the intake of Plaquenil is due to its affinity for melanin-containing structures in the body. Plaquenil Toxicity - Symptoms, Treatment, Risk Factors.. Visual Fields and Plaquenil Medical Billing and Coding.. Plaquenil Side Effects Common, Severe, Long Term -. A 53-year-old female with a complaint of something "funny" with her vision. The possibility of hydroxychloroquine toxicity was entertained, although clinical evidence was not found. Color vision testing and funduscopic examination were normal. A full field electroretinogram was normal, but foveal cone electroretinograms were reduced bilaterally. Apr 20, 2011 Additionally, color vision––helping in the assessment of macular integrity––was recommended as an optional test. There have been reports of color vision defects associated with chloroquinine- and hydroxychloroquinine-related retinal toxicity. 4 Other optional tests included multifocal electrophysiology mfERG testing and fluorescein. Lyons emphasizes the importance of annual screening and says that, although annual screening is recommended for everyone taking Plaquenil, it is imperative for people who have been taking the medication for more than 10 years, who have a higher incidence of retinal toxicity. Plaquenil-induced toxicity usually will not occur before five years of.