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CodeMap® 09/09/2005: LIS and Medical Necessity

CodeMap Compliance Briefing: 09/09/05


Editor's Welcome:

The following briefing was submitted by our Chief Information Officer, Mr. Gerald Tavolino. The briefing focuses on the importance of maintaining medical necessity data in Laboratory Information Systems (LIS).  This briefing will be technical in nature but hopefully familiar to those who use and maintain LIS.  Please feel free to contact our Chief Information Officer directly at if you have any questions.


Gregory Root, Esq.

The Importance of Medical Necessity Data in Laboratory Information Systems

Most LIS vendors include a function for checking CPT® codes against a list of ICD-9 codes that meet medical necessity requirements for Medicare patients. This function is called a “code-pair” check. As a new order is entered, the LIS will check its database of valid code-pairs.  If the CPT code and the ICD-9 code match, the order will proceed.&n....

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CPT copyright 2021 American Medical Association. All rights reserved.

* The responsibility for the content of any "National Correct Coding Policy" included in this product is with the Centers for Medicare and Medicaid Services and no endorsement by the AMA is intended or should be implied. The AMA disclaims responsibility for any consequences or liability attributable to or related to any use, nonuse, or interpretation of information contained in this product.

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