CII Frequently Asked Questions

What can a pharmacist add or change to a CII prescription?

After a pharmacist obtains approval of the prescribing practitioner who wrote the CII prescription, a pharmacist can add or change:

• The strength of the drug prescribed
• The quantity of the drug prescribed
• The directions for use
• The patient’s date of birth
• The ICD-10 code
• The day’s supply
• The date of issuance can be ‘corrected’, if written in error, but not changed (i.e. the practitioner inadvertently wrote the prior year on New Year’s Day of the current year).

Authority: NAC 453.440(5)(a)

What can a pharmacist not add or change to a CII prescription?

A pharmacist cannot add or change to a CII prescription:
• The name of the patient
• The name of the controlled substance (except a generic may be substituted for the controlled substance prescribed, in which case the name of the controlled substance can changed to the generic)
• The DEA registration number of the prescribing practitioner
• The signature of the prescribing practitioner

Authority: NAC 453.440(5)(b)

Can a pharmacist partially fill a prescription for a CII prescription?

A pharmacist may partially fill a CII prescription for the following scenarios:
• The pharmacist is unable to supply the full quantity called for on a written or electronic prescription or a partial fill is requested by the patient or prescribing practitioner. In either case the pharmacist must: (1) Note the quantity supplied with the original prescription, and (2) Fill any quantity of the remaining portion that is requested no later than 30 days of the date the prescription was issued. There is no limit to the number of times a prescription can be partially filled within the 30 days so long as the total quantity in all partial fillings does not exceed the total quantity that was prescribed.
• For an emergency oral prescription in which case the remaining quantity must be filled within 72 hours of the prescription being issued and a written prescription for the emergency supply must be received within 72 hours.
• The patient is in a long-term care facility or has been diagnosed as being terminally ill.

Authority: NAC 453.460(1)(a) and (b)

Can a pharmacist accept a faxed CII prescription?

Generally no. A CII prescription can be faxed by a practitioner to a pharmacy only when:

• The controlled substance will be compounded for the direct administration to a patient by parenteral, intravenous, intramuscular, subcutaneous or intraspinal infusion;
• The controlled substance is issued to a resident of a facility for long-term care; OR
• The controlled substance is issued to a patient enrolled in a licensed program that provides hospice care.

Authority: NAC 639.711(1)(a),(b), and (c)

Can a CII be written on the same prescription along with a prescription for another drug?

Yes, a CII can be written on the same prescription as another drug including another CII. If a CII is written on the same prescription with another drug, the pharmacy must:

• File the original in the CII files.
• Make a copy of the original prescription for each of the other prescriptions written on that prescription; and
• File the copy or copies in the files appropriate for those drugs. Each copy made must include a reference to the prescription number for the CII listed.
• If the prescription blank contains more than one controlled substance listed in schedule II, include on each copy of the prescription a reference to the serial number of the first prescription for a controlled substance listed in schedule II.

Authority: NAC 453.450(2)

How does the 14-day rule apply to CII prescriptions?

Generally a pharmacist cannot fill a CII prescription unless it is tendered by the pharmacy on or before the 14th day after the date of issue. “Tendered” means received by the pharmacy. The counting of the fourteen days begins on the day after the date on which the practitioner wrote the prescription, except where a CII prescription has a future fill, or “do not fill until” date written on it, in which case the fourteen days begins on the day after the future fill or “do not fill until” date.

Authority: NRS 453.431(4)

Can a CII prescription be post-dated?

No, a practitioner cannot post-date a CII prescription. Each prescription must be dated the day that the practitioner wrote it. However, a practitioner may write prescriptions to be filled at a future date by writing on the face of the prescription a phrase such as “Do not fill before (date)” or “Do not dispense until (date).” Three cautions regarding such prescriptions:

• The date of issuance of the prescription must be the date the practitioner actually wrote the prescription;
• The prescription must be received within 14 days of the “do not fill until” date to fall within the 14-day rule;
• The date indicated by the practitioner must not be later than 3 months after the date on which the prescription is written.
• Federal law prohibits the issuance of more than a 90-day supply using post-dated prescriptions.

Authority: NAC 453.450(4)

Can a CII prescription be written for more than a one month supply?

Nevada does not limit the quantity that a practitioner can prescribe for CII prescription or for any drug with the exception of one scenario due to the implementation of AB 474.
There are now some prescribing limits on an initial prescription for a controlled substance listed in schedule II, III, or IV for the treatment of acute pain and are as follows:
• Must be intended to be used for no more than 14 days
• Must not exceed 90 morphine milligram equivalents (MMEs) daily for opiate naïve

Authority: NAC 453.450(4)

Can a prescribing practitioner prescribe medication for a family member?

A prescribing practitioner cannot prescribe a CII (except in cases of emergency) for:

• Himself;
• His spouse; OR
• His children

Authority: NAC 453.381(1)