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1. congius (gallon)
The American Heritage® Medical Dictionary Copyright © 2007, 2004 by Houghton Mifflin Company. Published by Houghton Mifflin Company. All rights reserved.
medically necessaryManaged care adjective Referring to a covered service or treatment that is absolutely necessary to protect and enhance the health status of a Pt, and could adversely affect the Pt's condition if omitted, in accordance with accepted standards of medical practice. See Futility.
Medically necessary, criteria
a. Appropriate for the Sx and diagnosis or treatment of a condition, illness or injury
b. Provided for the diagnosis or the direct care and treatment of the condition, illness or injury
c. In accordance with the standards of good medical practice in the service area
d. Not primarily for the convenience of a plan member or a plan provider
e. The most appropriate level or type of service or supply which can safely be provided to the plan member
McGraw-Hill Concise Dictionary of Modern Medicine. © 2002 by The McGraw-Hill Companies, Inc.