Medically Indicated definition

Medically Indicated means a service or supply ordered by a Physician which is necessary in order to treat or care for symptoms of an illness or injury, or to diagnose an illness or condition that is harmful to life or health, and which is commonly and customarily recognized throughout the Physician's profession as appropriate in the treatment. The decision whether a service or supply ordered by the Physician was Medically Indicated for the purposes of qualifying for payment by the Health Care Plan rests with the Plan.
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Medically Indicated means Medical Care provided or ordered by Associate which is necessary in order to treat or care for symptoms of an illness or injury, or to diagnose an illness or condition that is harmful to life or health, and which is commonly and customarily recognized throughout the Associate's profession as appropriate treatment. The decision whether a service or supply ordered by the Associate was Medically Indicated for the purpose of qualifying for payment rests with the Plan.
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Medically Indicated means special milk formula indicated for infants with inborn errors of metabolism, i.e. galactosemia, phenylketonuria* and maple syrup urine disease;
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Examples of Medically Indicated in a sentence

  • The fact that a Physician has performed or prescribed a procedure or treatment or the fact that it may be the only procedure or treatment for a condition, Injury, or Sickness does not mean that it is Medically Indicated or of Medical Necessity.

  • Chlamydia trachomatis Is Associated With Medically Indicated Preterm Birth and Preeclampsia in Young Pregnant Women.

  • Medically Indicated Preterm Birth: Recognizing the Importance of the Problem.

  • Care and treatment for tobacco cessation programs, including smoking deterrent patches, unless Medically Indicated due to a severe active lung illness such as emphysema or asthma, unless such care is specifically covered under enrollment of the Plan’s disease management program.

  • O.A.C. 5101:2-36-07: PCSA Requirements for Conducting and Assessment/Investigation of the Alleged Withholding of Medically Indicated Treatment from a Disabled Infant with Life-Threatening Conditions8.

  • Sensitivity Analysis Considering Effect of Gestation of Preterm Birth, Recurrence of Preterm Birth, and Spontaneous Versus Medically Indicated Preterm Birth Sensitivity analyses were performed to consider the effect of gestation, recurrence, and spontaneous onset of preterm birth in the 5 cardiovascular outcomes that were significant in the adjusted studies.

  • Sara Rosenbaum et al., “An Analysis of the Implications of the Stupak/Pitts Amendment for Coverage of Medically Indicated Abortions,” The George Washington University Medical Center, November 16, 2009, at http://sphhs.gwu.edu/departments/healthpolicy/DHP_Publications/pub_uploads/dhpPublication_FED314C4-5056- 9D20-3DBE77EF6ABF0FED.pdf.

  • The decision whether a service or supply ordered by the Physician was Medically Indicated for the purposes of qualifying for payment by the Health Care Plan rests with the Plan.

  • Unlisted procedures ending in 99 with a charge of $1,000 or greater.NOTE - When a procedure requiring precertification is billed on claim with POS 23 (emergency room) or 20 (urgent care) Charge(s) can be allowed without authorization.Charges that are determined by Utilization Management not to be Medically Indicated are not Covered ComprehensiveMedical Charges, and no benefits will be paid for such charges.Procedures that require precertification are subject to change throughout the plan year.

  • Withholding Medically Indicated Treatment in Severely Disabled Infants with Life Threatening Conditions.


More Definitions of Medically Indicated

Medically Indicated means a vaccine is recommended by the ACIP for a person:
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Related to Medically Indicated

  • Medically fragile means the condition of a child who requires the availability of twenty-four-hour skilled care from a health care professional or specially trained staff or volunteers in a group care setting. These conditions may be present all the time or frequently occurring. If the technology, support and services being received by the medically fragile children are interrupted or denied, the child may, without immediate health care intervention, experience death.

  • Biologically-based mental illness means schizophrenia, schizoaffective disorder, major depressive disorder, bipolar disorder, paranoia and other psychotic disorders, obsessive-compulsive disorder, and panic disorder, as these terms are defined in the most recent edition of the diagnostic and statistical manual of mental disorders published by the American Psychiatric Association.

  • Medically incapacitated means a person who is incapacitated as a result of prescribed sedatives, anesthesia, or other medication.

  • Therapeutically equivalent drug products means drug products that contain the same active

  • Iatrogenic infertility means an impairment of fertility by surgery, radiation, chemotherapy, or other medical treatment affecting reproductive organs or processes.

  • Non-surgically implanted prostheses means a replacement body part not surgically implanted.

  • Mentally ill means having a mental illness.

  • inherited metabolic disease means a disease caused by an inherited abnormality of body chemistry for which testing is mandated by law;

  • Medically Appropriate means services and medical supplies required for prevention, diagnosis, or treatment of a physical or behavioral health condition or injuries that are:

  • Therapeutically equivalent means a drug product with the same efficacy and toxicity when administered to an individual as the originally prescribed drug as provided for in Section 39‑24‑40.

  • Initial Indication means the use of a Product for the treatment of opioid addiction.

  • medically approved means certified by a medical practitioner;

  • Intensive Care Unit means an identified section, ward or wing of a hospital which is under the constant supervision of a dedicated medical practitioner(s), and which is specially equipped for the continuous monitoring and treatment of patients who are in a critical condition, or require life support facilities and where the level of care and supervision is considerably more sophisticated and intensive than in the ordinary and other wards.

  • Adolescent means a Medicaid patient 17 years or younger.

  • Therapeutic diet means meals served that are soft, low-fat, low-sodium or controlled calorie.

  • Disease means an alteration in the state of the body or of some of its organs, interrupting or disturbing the performance of the functions, and causing or threatening pain and weakness or physical or mental disorder and certified by a Medical Practitioner.

  • Medically Necessary means a service which is appropriate and consistent with the treatment of the condition in accordance with accepted standards of community practice.

  • medical food means a food that is intended for the dietary treatment of a disease or condition for which nutritional requirements are established by medical evaluation and is formulated to be consumed or administered enterally under the direction of a Practitioner.

  • Additional Indication means any indication other than the Initial Indication.

  • Diagnostic Product means any test or assay for diagnosing or detecting a disease, disorder, medical condition, or symptom.

  • sickle cell disease means a hemolytic disorder characterized by chronic anemia, painful events, and various complications due to associated tissue and organ damage; "hemolytic" refers to the destruction of the cell membrane of red blood cells resulting in the release of hemoglobin.

  • Acutely mentally ill means a condition which is limited to a

  • Marihuana-infused product means a topical formulation, tincture, beverage, edible substance, or similar product containing marihuana and other ingredients and that is intended for human consumption.

  • geographical indication , in relation to goods, means an indication which identifies such goods as agricultural goods, natural goods or manufactured goods as originating, or manufactured in the territory of a country, or a region or locality in that territory, where a given quality, reputation or other characteristic of such goods is essentially attributable to its geographical origin and in case where such goods are manufactured goods one of the activities of either the production or of processing or preparation of the goods concerned takes place in such territory, region or locality, as the case may be.

  • Phase III Clinical Study means a human clinical study of a product on a sufficient number of subjects that is designed to establish that such product is safe and efficacious for its intended use, and to determine warnings, precautions, and adverse reactions that are associated with such product in the dosage range to be prescribed, which trial is intended to support Regulatory Approval of such product, as described in 21 C.F.R. 312.21(c). 1.185. [***] 1.186. [***]

  • Infectious Disease means an illness that is capable of being spread from one individual to another.