Medical Necessity Crosswalk

Title
Medical Necessity Crosswalk

File
GENLMRP

Description
The Medical Necessity Crosswalk lists the ICD-9 codes often considered medically necessary by Medicare Carriers and Fiscal Intermediaries for a particular CPT or HCPCS code. This file is based on a composite of multiple states' Local Medical Review Policies and is not specific to a particular Carrier or Intermediary.

If you require Medical Necessity crosswalks that are Carrier/FI specific, click here.

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Email: MedicalNecessityandComplianceSales@mmm.com

Record Layout Comma-delimited

	Field		Description
	1		CPT/HCPCS Code

	2		ICD-9 Code

click here to view data sample

We can prepare data files in ASCII text, comma-delimited, or fixed length formats per our customers' requests.

Update Schedule

	Month		Updates
	October		Monthly

Licensing Fees, Delivery, Copyrights

License fees are based on the number of workstations using the data files. The above price is for a non-transferable, non-exclusive single user license at a single site. Networks and other system prices are quoted individually.
Files may be delivered via email, CD, or by download from our dedicated FTP site.


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