New CVS Pharmacy Requirement for Controlled Substance Prescriptions
CVS Pharmacy has implemented a new nationwide policy requiring prescribers to include either a diagnosis or diagnostic code (ICD-10-CM) when prescribing any controlled substance. This policy stems from CVS’s 2023 Global Opioid Settlement and aims to help address prescription opioid abuse.
Key Points:
- Applies only to controlled substances.
- This is not a legal requirement in New York (except for 90-day supply prescriptions for specific indications).
- However, pharmacists may refuse to fill a prescription if the information is not provided.
- Dentists should include the diagnosis or code in the “Comments” field of their e-prescribing software. Example: “For use after dental surgery”
Resources for Diagnosis Codes:
- CDT Manual – See Section 3: ICD-10-CM Diagnoses for Dental Diseases and Conditions for relevant dental diagnosis codes.
- CDT Coding Companion – Contains Appendix 2: CDT Code to ICD (Diagnosis) Code Crosswalk. Free download under “Documents” at: Coding Education | ADA.
- CDC ICD-10-CM Code Search Tool – Enter a diagnosis to find the code: CDC ICD-10-CM Tool.
For additional guidance, contact the appropriate CVS Pharmacy directly or email nyssoms@nysdental.org.
