Per the 2018 TN Together Opioid Prescribing Law (Tenn. Code Ann. § 53-10-310), “when prescribing a controlled substance, all healthcare practitioners, unless otherwise exempted under this part, shall check the controlled substance database prior to prescribing one (1) of the controlled substances identified in subdivision (e)(4) to a human patient at the beginning of a new episode of treatment, prior to the issuance of each new prescription for the controlled substance for the first ninety (90) days of a new episode of treatment, and shall check the controlled substance database for that human patient at least every six (6) months when that prescribed controlled substance remains part of the treatment.

An authorized healthcare practitioner’s delegate may check the controlled substance database on behalf of the healthcare practitioner. A ‘new episode of treatment’ means a prescription for a controlled substance that has not been prescribed by that healthcare practitioner within the previous six (6) months.”

Exemptions to this were amended for clarification in the July 1, 2019 update to the law.  Providers can prescribe for patients that meet exempt categories by ensuring the prescription includes the ICD-10 diagnostic code and the word “exempt”:

 active cancer treatment
 palliative care treatment
 hospice care treatment
 sickle cell disease
 inpatients in the hospital
 prescriptions issued by pain management specialists or under the collaborative direction of a pain management specialist after that specialist or their APRN or PA have seen the patient
 patients who have been treated with daily opioids already for 90 days or more in the past 365 days
 methadone, or other products approved for treatment of opioid use disorder
 treatment with an opioid antagonist
 severe burn
 major physical trauma

 References:

• 2018 TN Together Opioid Prescribing Law
• TN Chronic Pain Guidelines and the CDC Guidelines