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Medical necessity solutions for business partners

Expert content for validation

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.

3M is an industry leading source for:

  • National and Local Coverage Decisions (NCDs and LCDs) for Medicare Part A and Part B claims
  • Specific state 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

Embedded content and edits

The 3M™ Grouper Plus System offers up-to-date claim edits for providers, payers, fiscal intermediaries, and state and federal agencies. You can choose the reimbursement methodology and calculate the expected reimbursement of individual claims based on the group assigned.

Microsoft Windows based content and edits

The 3M™ Core Grouping Software supports grouping, editing, and pricing of claims data 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 (for Medicare Parts A and B) within your existing health information system.

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Medical necessity solutions Integrated medical necessity validation where and when it is needed.