Speaking under my former hat as a Laboratory Director, if "culture if 
indicated" criteria are on file as approved by the ordering physician, you 
effectively have the order for the test. The trick is making sure the coders 
know to code the account with the appropriate diagnosis so you can get paid. At 
my former facility, we had a manual process to get the diagnosis added to 
outpatient orders before the coders got the order sheet, but that may not be 
practical for larger labs.
One possibility is to create a test that does not print on the report, but 
identifies when the culture has been reflexed. Perhaps a diagnosis field to 
indicate pyuria, hematuria, etc. so a report could be run daily for the coders 
to make sure they know what additional diagnosis to code on the account for 
those patients. As long as the physician(s) have signed off on the culture if 
indicated criteria, the coders can code the symptoms from the report results.
Paul
 

Paul Goedicke 
IT Analyst III 
Jackson County Memorial Hospital 
1200 E.Pecan, Altus, OK 73521 
Phone: (580) 477-7485 
Fax: (580) 477-7366 
Email: [EMAIL PROTECTED] 

-----Original Message-----
From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] Behalf Of Arthur, Jerri
Sent: Thursday, November 16, 2006 8:48 AM
To: [email protected]
Subject: [MEDITECH-L] LAB--Medical Necessity on Reflexed Orders



Posting for our lab analyst: 
Greetings - I was curious to know how other laboratories were using medical 
necessity on reflexed orders. More specifically, on a UA that is culture if 
indicated, how do you generate the medical necessity page when you add the UACU 
and where do you get the diagnosis. It would appear that the tech is making the 
diagnosis, but doesn't the doc have to do it? If the doc is supposed to supply 
the diagnosis, does she have to indicate that on the requisition? We're not 
getting reimbursed for some of our reflexed orders. Any help is always 
appreciated. Thanks. 

Scott Hubbard 
Clinical Analyst 
Stillwater Medical Center (IT) 
 <mailto:[EMAIL PROTECTED]> [EMAIL PROTECTED] 
405-742-5957 


Thank You, 
Jerri Arthur, MS
Applications Analyst
Information Technology
Stillwater Medical Center
1323 W 6th, Box 2408
Stillwater, OK 74074
405-742-5269
405-742-5971 fax
405-742-9266 pager
[EMAIL PROTECTED] 
Meditech Client Server, 5.5.2 

MUSE Western US Region Board Member 
Education/Scheduling Coordinator 



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