OptumRx is currently embarking on an initiative to curb the rising tide of opioid abuse across the US. Starting December 1, 2017, OptumRx Commercial Clients and Managed Medicaid clients will be enrolled in our new enhanced CDUR edits.

The suite of enhanced CDUR edits will be set for most clients as a soft reject with DUR-PPS override codes and are as follows: 

* Drug-Drug Interaction: opioid / benzodiazepine 

* Drug-Drug Interaction: opioid / prenatal 

* Drug- Drug Interaction: opioid secondary to Medication Assisted Treatment (MAT) therapy 

* Therapy Dose Check on APAP: cumulative therapy dose check on APAP exceeding FDA daily maximum of 4 grams 

* MEDLIMIT: cumulative therapy dose check on MED exceeding 90 mg

*Please see attached for more information*