As of July 1, new limits on opioid prescribing went into effect. For dentists writing an opioid prescription for a maximum three days and 180 Morphine Milligram Equivalents (MMEs,) there are no new restrictions.
A refill or second opioid prescription for the same condition requires the following steps. A new episode of care is eligible for a 3-day/180 MME prescription with no restrictions.
A dentist writing an opioid for more than a three-day supply is required to:
1. Check the Controlled substance database;
2. Write the appropriate ICD-10 code for the primary disease somewhere on the prescription;
3. Secure informed consent and provide counseling. *
Anthony Carroccia, DDS, at the behest of the Tennessee Academy of General Dentistry, has spent considerable time developing an abbreviated list of common dental ICD-10 codes for quick reference. Both a limited and a more inclusive array are appended below.
Click here for the abbreviated ICD-10 code list
Click here for the expanded ICD-10 code list
Click here for the MME calculator link
Click here for the TN-Together Flow Chart
*The Department of Health was expected to issue guidance as to how to comply with informed consent and counseling requirements for prescriptions exceeding three days at the July 12 Board of Dentistry meeting. Department liaisons accepted responsibility for not providing this promised information in a timely manner (July 1) as required by law. They promised to address both informed consent and patient counseling requirements within days. We will provide detailed information on such as soon as practicable.