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Coding patterns used by ophthalmologists for hydroxychloroquine retinal toxicity.

Stephan Y Chiu1, Jeremy W Shaw1, Tiffany Q Luong2

  • 1Eye Monitoring Center, Kaiser Permanente Southern California, Baldwin Park, CA, USA, bobmodj@gmail.com.

Clinical Ophthalmology (Auckland, N.Z.)
|November 23, 2018
PubMed
Summary
This summary is machine-generated.

Ophthalmologists often use varied ICD-9 codes for hydroxychloroquine (HCQ) retinal toxicity, leading to imprecise data. Improved coding standards are needed for accurate research on HCQ toxicity.

Keywords:
International Classification of Diseasesaccuracybillingcodingdatabasehydroxychloroquineplaquenilretinopathy

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Area of Science:

  • Ophthalmology
  • Medical Coding
  • Pharmacovigilance

Background:

  • Hydroxychloroquine (HCQ) is widely prescribed for autoimmune conditions.
  • Retinal toxicity is a known, albeit rare, complication of HCQ treatment.
  • Accurate identification of HCQ retinopathy is crucial for patient monitoring and research.

Purpose of the Study:

  • To analyze International Classification of Diseases, Ninth Revision (ICD-9) coding patterns for hydroxychloroquine (HCQ) retinal toxicity.
  • To evaluate the accuracy of ICD-9 codes in identifying confirmed cases of HCQ retinopathy.

Main Methods:

  • Retrospective cohort study of patients dispensed HCQ between 2001-2014.
  • Electronic search for specific ICD-9 codes related to maculopathy and retinopathy.
  • Manual chart review to confirm HCQ retinopathy diagnosis.

Main Results:

  • Of 23,362 patients on HCQ, 678 received relevant ICD-9 codes; 53 had confirmed HCQ toxicity.
  • 35 of 43 patients coded for toxic maculopathy had HCQ toxicity (81.4%).
  • 32.1% of patients with confirmed HCQ toxicity received codes other than toxic maculopathy.

Conclusions:

  • ICD-9 coding for HCQ toxicity is often imprecise, with frequent use of non-specific codes.
  • A notable proportion of toxic maculopathy codes do not represent actual HCQ toxicity.
  • Standardizing coding practices for HCQ retinopathy is essential for research accuracy and patient care.