Ultra-Rapid Opiate Detoxification (UROD)

Policy ID: A-18-007

Section: Anesthesia

Effective Date: May 01, 2020

Revised Date: March 16, 2020

Revision Effective Date: September 02, 2024

Last Reviewed: July 16, 2024

Applies To: Commercial and Medicaid Expansion

Description

The use of relatively high doses of opioid antagonists under deep sedation or general anesthesia is a technique for opioid detoxification and is known as ultra-rapid detoxification. It is a potential alternative to standard detoxification that allows individuals to avoid the acute symptoms associated with initial detoxification. Ultra-rapid detoxification is used in conjunction with maintenance treatments, e.g., oral opioid antagonists and psychosocial support .

Criteria

Coverage is subject to the specific terms of the member's benefit plan.

Policy Application

All claims submitted under this policy's section will be processed according to the policy effective date and associated revision effective dates in effect on the date of service.

UROD is considered experimental/investigational and therefore non-covered as a clinical detoxification treatment because its effectiveness has not been established.

Procedure Code

01999

Diagnosis Codes

Not Applicable

Professional Statements and Societal Positions Guidelines

Not Applicable

ND Committee Review

Internal Medical Policy Committee 3-13-2020 New Policy

Internal Medical Policy Committee 3-17-2021 Annual Review-no changes

Internal Medical Policy Committee 3-23-2022 Annual Review-no changes in criteria

Internal Medical Policy Committee 1-26-2023 Annual Review no changes in criteria

Internal Medical Policy Committee 7-16-2024 Annual Review - no changes in criteria

Added Policy application; and
Added Coverage statement.

Links

References (PDF)

Disclaimer

Current medical policy is to be used in determining a Member's contract benefits on the date that services are rendered. Contract language, including definitions and specific inclusions/exclusions, as well as state and federal law, must be considered in determining eligibility for coverage. Members must consult their applicable benefit plans or contact a Member Services representative for specific coverage information. Likewise, medical policy, which addresses the issue(s) in any specific case, should be considered before utilizing medical opinion in adjudication. Medical technology is constantly evolving, and the Company reserves the right to review and update medical policy periodically.

Policy ID: A-18-006

Section: Anesthesia

Effective Date: May 01, 2020

Revised Date: March 16, 2020

Revision Effective Date: March 04, 2024

Last Reviewed: January 16, 2024

Archived Date: September 01, 2024

Applies To: Commercial and Medicaid Expansion

Description

Criteria

UROD is considered experimental/investigational and therefore non-covered as a clinical detoxification treatment because its effectiveness has not been established.

Procedure Codes

01999

Diagnosis Codes

Not Applicable

Professional Statements and Societal Positions Guidelines

Not Applicable

ND Committee Review

Internal Medical Policy Committee 3-13-2020 New Policy

Internal Medical Policy Committee 3-17-2021 Annual Review-no changes

Internal Medical Policy Committee 3-23-2022 Annual Review-no changes in criteria

Internal Medical Policy Committee 1-26-2023 Annual Review no changes in criteria

Internal Medical Policy Committee 1-16-2024 Annual Review no changes in criteria

Links

References (PDF)

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