Phrase used in statistics that explains patients in the same diagnosis-related groups (DRGs) that are anticipated to have a set of clinical responses that result in a comparable pattern of use of medical services and supplies.

Medical care given only when an individual is ill with emphasis on the diagnosis and treatment of disease instead of health promotion and prevention of disease.

1. Performance of services and procedures required by the patient, indispensable, and consistent with the diagnosis in accordance with standards of good medical practice, performed at the proper level, and provided in the most appropriate setting. Medical necessity must be established (via diagnostic and/or other information presented on the individual claim under consideration) before the carrier may make payment. 2. Cal. Wel. & Inst. Code 14059.5 defines medical necessity when it is reasonable and necessary to protect life, to prevent significant illness or significant disability, or to alleviate severe pain. Also see medically necessary care .

Specific nutritional procedures including assessment, counseling sessions, and interventions in the treatment of an acute or chronic illness, injury, or disease condition. MNT is provided by registered dietitians (RDs) and state-licensed dietitians.

Medical transcriptionist who checks medical reports that have blanks or questionable terminology and flags them for correction by the dictator. See also medical editor (ME) .

In workers’ compensation insurance, group of health care providers created by an insurer or self-insured employer to treat workers injured on the job.