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Medical Necessity and CPT/Price Fee Schedule
Medical necessity definitions relate to LMRP rules and ABN functionality. They are also used in generic test to ICD limitation rules. The tables below are used by the system in rules processing related to these concepts. These tables also allow the definition of test code to CPT and price cross references used in payments and price calculation rules.
Tables containing medical necessity and CPT/Price fee schedule definitions are:
- FO_CPTReview
- FO_CPTReviewCombinedDx
- FO_LISxHIS
- FO_ICD9
- FO_MedicalNecessity_Form_Definition
- FO_Fee_Schedule_Definition
- FO_Fee_Schedule_Option_Definition