Policies-St. Dominic Hospital Reference Laboratory - Mayo Medical ...

Policies—St. Dominic Hospital Reference Laboratory
Billing—CPT Coding
It is your responsibility to determine correct CPT codes to use
for billing. This catalog lists CPT codes in an effort to provide
guidance. CPT codes listed reflect our interpretation of CPT
coding requirements and are not necessarily correct. You
should verify accuracy of codes listed and only select codes for
tests actually performed on your specimen. ST. DOMINIC
HOSPITAL REFERENCE LABORATORY SERVICES
ASSUMES NO RESPONSIBILITY FOR BILLING
ERRORS DUE TO RELIANCE ON CPT CODES LISTED
IN THE CATALOG. For further reference, please consult the
CPT Coding Manual published by the American Medical
Association. For questions concerning the use of a code, please
contact your local Medicare provider.
Billing—St. Dominic Hospital Reference
Laboratory Client
Bills are sent to clients by the 10 th of each month. The itemized
statement indicates the date of service, patient name, account
number, CPT code, test name, and test charge. Payment terms
are net 30 days. When making payment, please include the
invoice number if provided. If billing statement does not have
an invoice number, please send final page of statement being
paid. For all client bills, include any adjustment information
when payment is sent.
Billing—St. Dominic Hospital Reference
Laboratory Self Pay Patient
Bills are sent to patients as service is rendered. Patient bills are
itemized and include date of service. Patients should reference
account number on bill when making payment. When a patient
has a question about a charge, the laboratory will assist in the
process to assure that the review is done expeditiously and that
resolution is obtained in a timely manner. For patient billing, the
client must provide the following:
• Patient’s correct mailing address
• Patient’s sex
• Patient’s date of birth
• Patient’s Social Security number
• Patient’s phone number
Billing—St. Dominic Hospital Reference
Laboratory Third Party Payor
Third party payor billing is an option. The client must provide
the following:
• Patient’s full name (first, last, and middle initial)
• Patient’s sex
• Patient’s date of birth
• Patient’s complete mailing address
• Guarantor or subscriber full name, if other than patient;
patient’s relation to guarantor or subscriber; guarantor’s
address; and guarantor’s date of birth
• Insurance company, insurance company address,
insurance group number, and insurance identification
number - please provide a copy of the insurance card
(front and back)
• Medicare/Medicaid number if applicable. This must be
the patient’s number, not the spouse’s number.
Blood Bank Specimens
The American Association of Blood Banks, in their Standards
for Blood Banks and Transfusion Services (21 st edition, 2002),
requires that blood specimens to be used in the preparation of
blood for transfusion be:
• Labeled in the presence of the intended recipient
• Specimen label contain 2 independent patient identifiers
plus draw date
• A mechanism to identify the individual who drew the
blood
Specimens sent to St. Dominic Hospital Reference Laboratory
for transfusion-associated tests need to meet these
requirements.
Confidentiality
Members of the laboratory staff from professional, clerical, and
phlebotomy have access to numerous confidential documents.
Therefore, the potential could arise for a breach of
confidentiality. Unless required for the care of a patient or
client, all staff must refrain from discussing confidential
information within the laboratory and outside the laboratory.
No information, no matter how small and insignificant the
information may seem, is to be discussed or disclosed without a
patient’s approval. Breach of confidentiality can be grounds for
termination.
Conflict of Interest
Members of the laboratory staff from the professional staff to
the bench technologist have numerous contacts with other
business interests. Therefore, the potential could arise for a
conflict of interest in either the acquisition of services from an
outside company/agency or the motive of personal gain or

profit. It is a requirement of all laboratory supervisory and
administrative personnel to address any potential conflict of
interest by announcing prior to any consideration of business,
any potential interest that the pathologist, administrator,
manager, or supervisor has in a given company’s products or
services. In such instances, the pathologist, administrator,
manager, or supervisor shall make full disclosure to all other
parties involved in the negotiation and shall excuse himself/
herself from any consideration in the decision to purchase or
engage in a business relationship with that entity.
Critical Values
Some laboratory procedures have values so abnormal they
indicate an immediate threat to the patient’s life. Critical values
are listed in the “Reference Values” section of the test catalog
for each laboratory test with critical values. Critical values are
processed as follows:
• When the technologist notes abnormal values on a
patient that may indicate an immediate threat to the
patient’s life, the laboratory technologist will
immediately repeat test to verify result unless it is
consistent with a previous result.
• Immediately after critical result is verified, the
technologist will telephone report to physician, office
nurse, or designee. After office hours, the answering
service will be asked to page physician or nurse on-call.
For client hospitals, critical results will be called to
laboratory or nursing supervisor. Critical results must be
given to the appropriate care giver, only.
• Technologist calling critical value will ask nurse or other
care giver to “repeat back” patient name and critical
result to ensure that no communication problem is
encountered.
• Technologist will attach a footnote to critical result
noting the person notified, date and time of notification,
and comment, “verification read back of critical result
received.”
Material Safety Data Sheets
Material Safety Data Sheets for items supplied by St. Dominic
Hospital Reference Laboratory may be obtained by contacting
St. Dominic Hospital Reference Laboratory Client Services at
601-200-6710.
Reflex Testing
If reflex testing is not required, St. Dominic Hospital Reference
Laboratory must receive notification in writing. Letters for
blanket reflex tests are mailed and signed by clients annually.
Reportable Disease
Diseases of major public health importance are reported to
Mississippi State Department of Health as required by law. In
an effort to follow guidelines mandated by the Mississippi State
Board of Health (MSBH), personnel will report infectious
disease results to MSBH Epidemiology Department as outlined
in Section III of “The Mississippi State Department of Health
Rules and Regulations Governing Reportable Diseases and
Conditions.” A current copy of this section is available in the
Microbiology Department at St. Dominic Hospital Reference
Laboratory.
Laboratory personnel will report only client results, because
these results are not sent to the Infection Control Department of
St. Dominic Hospital Reference Laboratory. Due to limited
patient information provided by clients, personnel will report
only demographic information that is available and will
document the health facility or client account as ordering
health-care provider. The facility may be contacted by MSBH
for additional information at a later date. All reportable disease
testing sent to a St. Dominic Hospital Reference Laboratory
outside reference laboratory will be reported directly to MSBH
by that entity.
Supplies
Supply order request forms are provided to clients listing what
items are furnished by St. Dominic Hospital Reference
Laboratory. Supply usage is monitored by St. Dominic Hospital
Reference Laboratory Client Services in order to maintain
compliance with regulatory requirements.
Test Result Call-Back and Faxing
Results will be faxed or phoned to a client when requested by
the client. The request can be noted on the request form or by
contacting client services.
Test Turnaround Time
The laboratory is a full service department that operates 7 days
a week, 24 hours a day. The laboratory strives to complete all
testing performed in-house within a timely manner. This
catalog lists the days on which test is set up as a guide for
expected turnaround times. Turnaround times may be extended
due to specimen integrity problems such as incorrect,
hemolyzed, or contaminated specimens.