Refilling Schedule II Opioids if Out of Country

[dhcofc]

Is there any way to provide a patient with more than one month of opioids to be filled before leaving the country on an extended business trip? My understanding is that I can only fill 30 days worth of Schedule II's to be filled immediately and any further scripts must have a do not fill date for 30 days later. In other words, is there a way for a patient of mine traveling overseas for 2-3 months to fill opioids for this time frame before leaving? I know legally 90 days is the longest duration that can be prescribed without seeing the patient again.

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[lobelsteve]

Depending on your practice setup and your relationship with a patient the DEA certainly allows up to 90 days of medications. I believe the 30-day rule is a clinical guideline to allow the doctor to make more money off of patients that don't need care or to have frequent visits with patients who probably shouldn't be on pain medicine anyway. There's a level of risk and It's gotta be between 30 and 90 days depending on the patient.

 

[Ducttape]

you have to specify the duration of the therapy and you have to put "Code D" on the prescription itself....

so, for example,
"Tramadol 50 mg
sig: 1 tablet every 6 hours as needed for pain.
disp: #360 Code D 90 day supply.
refills: zero"

 

[Ligament]

What does Code D mean? are there other secret codes?

 

[Ducttape]

the Codes.

4. Controlled substances may only be prescribed in a maximum thirty-day supply.
False: A practitioner may issue a prescription for up to a threemonth supply of a controlled substance, including chorionic gonadotropin, or up to a six-month supply of an anabolic steroid by writing on the face of the prescription either the diagnosis or code for the treatment of the following conditions:

Code Diagnosis
A Panic Disorder
B Attention Deficit Disorder
C Chronic debilitating neurological conditions characterized as a movement disorder or exhibiting seizure, convulsive or spasm activity
D Relief of pain in patients suffering from conditions or diseases known to be chronic or incurable
E Narcolepsy
F Hormone deficiency states in males; gynecologic conditions that are responsive with anabolic steroids or chorionic gonadotropin; metastatic breast cancer in women; anemia and angioedema