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 a vaccine is recommended by the ACIP for a person:
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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

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

  • Dosage and Types of Immunizations• 1 dose of Td or Tdap• 1 dose of Meningococcal• 2 or 3 doses of HPV – to qualify for two doses, the patient must have the first dose prior to their 15th birthday, and the two doses must be separated by a minimum of five months.Not Medically Indicated Refusal, Contraindication, and Evidence of Disease InformationNMI refusals and contraindications for individual immunizations will also count toward meeting the definition, as defined in the following section.

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

  • Dosage and Types of Immunizations• 1 dose of Td or Tdap• 1 dose of Meningococcal• 2 or 3 doses of HPV—in order to qualify for 2 doses, the patient must have the first dose prior to their 15th birthday and the 2 doses must be separated by a minimum of 5 monthsNot Medically Indicated (NMI) Refusal and Contraindication InformationNot Medically Indicated refusals and contraindications for individual immunizations will also count toward meeting the definition, as defined in the following subsections.

  • 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.

  • Grievances: Referral lost or incomplete, Staff behavior, Perceived lack of caring/concern, Denials/Actions: Not Medically Necessary, Not Medically Indicated, Partial Approval, Not a Covered Benefit, Contract Exclusion, No Benefit, Limited Benefit/Excluded, , Benefit Exceeded/Exhausted, Out of Network, Not A Contracted Provider, Non-Preferred Provider, Care Available from participating provider, No Referral, RX criteria not met, Investigational/Experimental, etc.

  • Systematic Review of Factors Influencing Non- Medically Indicated Formula Supplementation of Newborns in the Hospital Setting.

  • You or your authorized representative must submit this appeal in writing on a request for formal hearing form, which will be attached to 1st level formal appeal decision letter, within 60 days after you have been informed of the resolution of the 1st level formal appeal.Exhaustion of the 1st level formal appeal procedure is a precondition to filing a 2nd level formal appeal.

  • Dosage and Types of Immunizations• One dose of Td or Tdap• One dose of Meningococcal• Three doses of HPVNot Medically Indicated Refusal, Contraindication, and Evidence of Disease InformationNMI refusals and contraindications for individual immunizations will also count toward meeting the definition, as defined in the following section.

  • Dosage and Types of Immunizations• 1 dose of Td or Tdap • 1 dose of Meningococcal• 2 or 3 doses of HPV—in order to qualify for 2 doses, the patient must have the first dose prior to their 15th birthday and the 2 doses must be separated by a minimum of five monthsNot Medically Indicated (NMI) Refusal and Contraindication InformationNot Medically Indicated refusals and contraindications for individual immunizations will also count toward meeting the definition, as defined in the following subsections.


More Definitions of Medically Indicated

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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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 ingredients and are identical in strength or concentration, dosage form, and route of administration and that are classified as being therapeutically equivalent by the U.S. Food and Drug Administration pursuant to the definition of "therapeutically equivalent drug products" set forth in the most recent edition of the Approved Drug Products with Therapeutic Equivalence Evaluations, otherwise known as the "Orange Book."

  • 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.

  • Medically stationary means that no further material improvement would reasonably be expected from medical treatment or the passage of time.

  • 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

  • Phase III Trial means a Clinical Trial of an investigational product in subjects that incorporates accepted endpoints for confirmation of statistical significance of efficacy and safety with the aim to generate data and results that can be submitted to obtain Regulatory Approval as described in 21 C.F.R. 312.21(c), or a comparable Clinical Trial prescribed by the relevant Regulatory Authority in a country other than the United States.

  • Fully vaccinated means the employer has documented that the person received, at least 14 days prior, either the second dose in a two-dose COVID-19 vaccine series or a single-dose COVID-19 vaccine. Vaccines must be FDA approved; have an emergency use authorization from the FDA; or, for persons fully vaccinated outside the United States, be listed for emergency use by the World Health Organization (WHO).

  • 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.