Test utilization management software for labs, providers and payers

Medical necessity, settled before you order

Search 2,300+ lab tests and 850+ diseases. Every test is scored 0–10 for the diagnosis, with the CPT and ICD-10 codes and the Medicare policy that support it.

Explore our products

Run a Quick Medical Necessity Check before diving into the full LDS workflow.

Pick a test, add the diagnosis and your state, and see in seconds whether the order meets medical necessity, with the Medicare LCD or NCD that applies. Free, with no account needed.

Checking several tests at once, or on the go? Try the LabNecessity App on Android. iPhone version coming soon.

Quick Necessity Check

A fast preview of the LDS ordering logic.

  • 1Select a test and review associated CPT codes
  • 2Add disease context and ICD-10 pairings
  • 3Check medical necessity against state policy inputs

70+

Professionals Involved

2300+

Medical Tests Covered

850+

Diseases Covered

A Data-Driven Approach to Medical Necessity & Clinical Relevance

Powering our LDS, CPOE, and Lab AI, our scoring system assigns each test a score from 0 to 10 based on clinical evidence, expert judgment, and quantitative data. By color-coding these scores (green, yellow, red), healthcare professionals gain clear guidance on which tests are most crucial for diagnosing or ruling out a condition. This improves both the clinical relevance of the tests ordered and their likelihood of reimbursement.

Scores of 7–10 (Green) signal highly relevant tests

Scores of 5–6 (Yellow) indicate optional or supportive tests

Scores of 0–4 (Red) help identify less relevant tests

Start Your Journey

Works inside the systems you already use

Scores, codes and coverage checks show up where your teams already order and bill, so there is no new screen to learn.

  • Connects through HL7, FHIR or our API
  • Can integrate with platforms including Allscripts, athenahealth and Epic
  • Content continuously updated by medical experts

Connects with

  • EMR and EHR
  • LIS
  • HL7
  • FHIR
  • API
  • Web, iOS, Android

Frequently Asked
Questions

Have questions about how Medical Database’s solutions streamline test ordering, improve medical necessity, or simplify reimbursement? Below you’ll find answers to some of the most common inquiries we receive from healthcare providers, laboratories, payers, and more.

Medical Database is a software company that specializes in providing evidence-based solutions for test ordering, reimbursement, and laboratory management. Our goal is to help healthcare providers reduce unnecessary testing, improve medical necessity compliance, and streamline clinical workflows.

Medical Database offers six core products: LDS App – A bedside guidance tool that assists providers in selecting and utilizing the most appropriate tests, CPOE – A computerized provider order entry system that improves the accuracy of test selection at the point of order, Eligibility Check – A coverage verification tool that confirms active coverage and payer details before the test is ordered, Lab AI – A claim verification and analytics solution, improving medical necessity and optimizing reimbursement, LDS®Rx – An advanced interpretation software for infectious pathogen and antibiotic resistance testing, supporting antibiotic stewardship for any infection, LabNecessity – A mobile app that checks lab tests against Medicare coverage policies (NCDs and LCDs) before the claim is submitted.

Our proprietary scoring algorithm evaluates each test’s relevance and necessity for a given diagnosis, assigning a 0–10 score and a color code (green, yellow, red). This makes it easier for physicians and laboratories to choose the most clinically appropriate tests while reducing the risk of denied insurance claims.

Our solutions are designed with seamless integration in mind. We provide APIs and HL7 interfaces that easily connect to most LIM, EMR, and EHR platforms. This lets patient data, test orders, and lab results flow securely and efficiently between systems.

We continuously update our test database and scoring system based on the latest clinical guidelines, Medicare/Medicaid rules, and industry best practices. This helps labs and providers stay current on regulations, minimize unnecessary tests, and maintain reimbursement eligibility.

Our products are designed for a wide range of users: hospitals, laboratories, payers, EMRs, providers, and even educational institutions. Any organization looking to improve test utilization, reduce costs, and stay compliant with medical necessity guidelines can benefit from Medical Database’s tools.

Ready to Order Smarter and Get Paid for It?

See how our products work together to reduce unnecessary testing, prevent denials and improve reimbursement.

Request a demo
  • Reduce Unnecessary Testing

  • Improve Medical Necessity Compliance

  • Optimize Reimbursement

Quick Medical Necessity Check