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Requisitions and ambiguous orders
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The page below is a sample from the LabCE course
Medicare Compliance for Clinical Laboratories (retired)
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Requisitions and ambiguous orders
Requisitions must be designed to ensure that ordering physicians can choose tests that are medically necessary for their patients.
Requisitions should contain reminders about Medicare rules of medical necessity and list the contents of panels and profiles.
Requisitions must provide a place for the physician to include diagnosis (ICD9-CM) codes.
Physicians should be encouraged to use only the requisitions supplied by the laboratory to order tests.
Ambiguous or unclear test orders
When the orders for a test are not absolutely clear, the laboratory must contact the ordering physician to clarify the orders before performing and billing for the test.
The laboratory cannot guess at the order.
The laboratory cannot perform and bill for tests that are not specifically ordered.
The laboratory cannot change a physician order without contacting the physician.
In any case where specimen integrity or patient care will be compromised by a delay in testing follow the policies the laboratory has established for such cases.
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