Health Information Systems

Medical necessity solutions for business partners

3M medical necessity solutions for business partners are designed for easy integration and provide medical necessity validation at one or more key points in the enterprise workflow.

Our skilled team of experts produce and deliver monthly medical necessity content. We can provide your customers with timely content for:

ICD-9 and ICD-10 National and Local Coverage Decisions (NCDs and LCDs) for Medicare Part A and Part B claims
State-specific Medicaid and payer-specific data
Supporting ICD-9 diagnostic codes for given HCPCS level 1 and level 2 codes (HCPCS 1 & 2); modifiers; restrictions for frequency, age and gender; non-allowed diagnosis codes for given HCPCS 1 & 2 codes; and non covered HCPCS 1 & 2

Medical necessity solutions

Integrated content and edits
The 3M™ Grouper Plus Content Services (PDF, 157 KB) offers cloud-based content that delivers medical necessity checking within your application. Your customers can choose the grouping methodology, editing and reimbursement calculation options for comprehensive high-speed claims processing.
Individual and batched claims processing
The 3M™ Core Grouping Software (PDF, 484 KB) supports grouping, editing (including medical necessity validation), and reimbursement calculation for individual and batched claims using a Microsoft® Windows® platform.
Embeddable data files
Would you like to leverage your existing health information system applications for a medical necessity solution? Consider embedding the 3M™ Medical Necessity Dictionaries within your existing applications for validation at any point in the customers’ workflow.