CDOS Service - Co-Dispensed Opioid

What are the rules to identify which patients qualify?

Patients being dispensed Methadone (or Suboxone) weekly or less, who also take at least one other non opioid medicine at the same frequency as the opiate are eligible for the Co-Dispensed Opioid Service (CDOS). 

Other medicines received by the patient will be paid at the higher rate (which for the present is the same as the ARRC service rate). 

Patients who are not dispensed other medicines at the same frequency as their opioid medicine are not eligible for the CDOS service.

Adding patients to CDOS Service

To put a patient in the CDOS service, select patient in Rx entry form, press F3 LTC/Services,  S Patient Services,

Press F3 Start Service and select 4 CDOS.

If the start date is inaccurate it can be edited in the Patient Services screen.

NB: This is the ONLY way to start the CDOS service. 

Even if  a patient is (is put into) in a suitably named institution, the CDOS service must still be started from the Patient Services screen.

Group CDOS patients for reporting

It may be useful to group these patients in a suitably named “institution” for review and/or reporting purposes.

• Go to 5. Dosepack

• 7. Administration 

• 1.Institution maintenance 

• F3 Add

• Give the institution a sensible name to reflect its purpose. Maybe further explain in the note?

• The Service Type for this institution should be left as "Non Specified"

NB: It is no longer necessary for a patient to be in an institution in order to get the CDOS service payments. 

This was a historical requirement that is superceded by the registration in the patient services screen.

LTC patients?

If any of these patients are currently getting the LTC service they must be exited from the service and given a status of EXIT - Other.

It is possible for a patient to be LTC at one pharmacy and receive CDOS at another although this is unlikely, any one pharmacy cannot deliver both LTC and CDOS services to the same patient.

Co-Dispensed Opioid Service - FAQ

Q. Do all my Methadone patients automatically qualify for CDOS?

A. Unlikely. Only patients who are getting at least one other medicine dispensed at the same frequency as the opiate, qualify to have other non-opiates paid at the CDOS rate.

Operational guidelines say: “The co-dispensing of these pharmaceuticals must be at least weekly (or more frequently) and supplied at the same time as the dispensing of the Methadone or Suboxone”

Q. Can my CDOS patients be in an institution?

A. Yes, but they don’t have to be. It may be useful for pharmacy to put their CDOS patients in an institution for reporting or other purposes, but it is not necessary.  CDOS is a patient-based service, NOT an institution based one like Residential Care services ARRC and CRC.

Q. How do I know if my CDOS patient is currently registered?

A. The service label. No label, no non-opiate dispensing payments.

Q. How do I manage my CDOS patient registrations?

A. Use the F3 LTC/Services function key after patient selection.  All patient services can be started and ended from this screen. If the patient goes in and out of the service that can easily be represented by starting and ending the service appropriately.  This builds a service history.

Q. So how can I check my CDOS patients?

A. Use the Patient Services report.  Go to 3 Reports, 9 patient Services and select Service type of CDOS, leave everything else blank for a list of currently registered CDOS patients.  If the patients are not on this list – they are NOT registered for CDOS.

Q. What is wrong with having patients marked CDOS who don’t have at least one other medicine dispensed at the same frequency as the opiate?

A. The opiates claim, and are paid, at the same rate regardless BUT if the patient is dispensed any other medicine, it will be paid at the CDOS rate when the patient does not qualify for this.  This could be tricky to explain to Audit and Compliance.