New Check for Opioid Drug Interaction

Beginning October 1, 2018, NC Medicaid will introduce a new edit into NCTracks pharmacy claim processing to provide a further check for opioid and benzodiazepine interactions. The new edit will identify a drug interaction for an opioid analgesic or benzodiazepine when it is determined that there is overlapping use of a different opioid or benzodiazepine within the previous 68 days.

Pharmacy claims failing the new check will deny with edit 59290 - SUPPLEMENTAL DRUG-2-DRUG INTERACTION. In the case of extenuating circumstances, the edit can be overridden with a submission clarification code of ‘10’.

For additional information on the NC Medicaid commitment to curtail opioid abuse, refer to the “Opioid Criteria Educational Materials” on the Pharmacy Services webpage of the NCTracks provider portal.