IMO® Medical Necessity
IMO® Medical Necessity provides the detailed code pairings of your Local Coverage Determinations (LCDs) with that of the National Coverage Determinations (NCDs) in simple tables which are easily implemented in your application. The purpose is to prevent documentation errors and denials of coverage that occur when clinicians unknowingly order tests and procedures that are not reimbursable by Medicare without appropriate justification.
How and Where Can It Help Me?
The average clinician cannot keep up-to-date knowledge of all the myriad of policies that affect an institution's Medicare reimbursements. This in turn affects claims to private insurers, as they typically follow Medicare's guidelines. By providing IMO® Medical Necessity, we can help eliminate lost billing while improving reimbursement recovery and timeliness. Our team of coders and physicians review monthly updates to provide you the most detailed level of coverage.
The ideal solution is to start earlier in the process and employ checks on every clinician order to see if the ICD-9-CM coded diagnoses justify the CPT® or HCPCS-coded orders. IMO® Medical Necessity provides healthcare organizations a route for a big payback on a small investment. We take care of the medical necessity checking for you as well as the regular updates for different payors and areas of the country, and provide the necessary tools
to help you get started quickly and easily. IMO provides expert implementation and support services for those who need assistance.
Three Technology Versions to Fit Every Implementation Need
Pick the programming environment best for you by choosing from one of several IMO® Medical Necessity modules available:
- Microsoft's .NET web services
- A compiled list of code pairings in TAB- or CSV- delimited text format, which you may choose to have include links of the complete text for the associated policy
- A dynamic link library (.DLL) with a compressed binary index file, which allows developers of computerized patient records or clinical systems to easily utilize the full power of IMO® Medical Necessity
Check Out the Medical Necessity Demo Now! Click Here
CPT® is a registered trademark of the American Medical Association.
National Correct Coding Initiative policies are a product of the Centers for Medicare and Medicaid Services.