Lab User's Guide


Welcome to Deaconess Hospital Laboratory (DHL) and Deaconess Regional Laboratory (DRL).  We are a full service laboratory offering comprehensive clinical and anatomic pathology testing to the tri-state medical community.  We strive to maintain excellence in laboratory services and to provide you with professional assistance in laboratory medicine.

Our laboratory employs highly trained professionals and support staff.  State of the art instrumentation, techniques and data processing allows us to deliver laboratory services backed by quality assurance programs and accreditation by the College of American Pathologists.

This User’s Guide represents the efforts of supervisors, pathologists, technologists, and support staff to provide you with a comprehensive and practical guide to our laboratory services.  It is intended to assist you in the ordering and collection of laboratory work on your patients.  Should you need additional information, please phone Deaconess Hospital Laboratory.

This User’s Guide and the most current information can be found on the Deaconess Web site, deaconess.com/lab

Please address any questions or comments to the Deaconess Hospital Laboratory, 600 Mary Street, Evansville Indiana 47747 or phone 812-450-3345.


Phillip Gamble, MA, MT (ASCP)
Laboratory Manager


Henry W. Bockelman, M.D.
Laboratory Medical Director

Laboratory Operations

The hospital’s laboratories are located at Deaconess Hospital 600 Mary Street Evansville Indiana and at the Gateway Hospital 4011 Gateway Blvd. Newburgh Indiana.  Both campuses provide service 24 hours a day, seven days a week with Medical Technologists on duty and a Pathologist available at all times.

Deaconess Regional Laboratory Patient Service Centers >>


Pathology Consultation

The Pathologist on-call may be contacted for services needed after normal working hours, on Sundays and on holidays.  Personnel in the Lab may be contacted 24 hours a day for assistance, by phoning 812-450-3386. If administrative problems arise during or after normal working hours, please contact the Laboratory Manager (812-450-3345), one of the supervisors or laboratory sections. 

Accreditation / Licensure

Deaconess Hospital Laboratory maintains a current CLIA certificate with the U.S. Department of Health and Human Services Centers for Medicare and Medicaid Services (CMS), is accredited by the College of American Pathologists (CAP), and holds all other necessary state licenses.  For additional information or copies of our certificates, please refer to our Web site at deaconess.com or contact the Laboratory Administrative office at 812-450-2483.

Reference Laboratory Testing

Some tests are referred from our laboratory to a reference laboratory and require additional turnaround time for transport to that lab.  A number under the test code on the far right side of each test listing can identify these tests.

General Information

Medicare Coverage of Lab Tests Test Turnaround Time
Panels Cancellation of Tests
Referral Testing Confidentiality of Results
Reporting HIV Screening
Supply Orders Informed Consent Certification
Amended Reports Critical Values
Billing Patient Identification Accuracy
Billing - CPT Coding Reference Ranges
Alphabetical Test List Description Specimen Rejection
Animal Specimens Specimen Transport
Computer Downtime  

 

 

Medicare Coverage of Laboratory Tests

When ordering outpatient laboratory tests billed to Medicare/Medicaid or other federally funded programs, the following requirements may apply:

  • Only tests that are medically necessary for the diagnosis or treatment of the patient can be billed to Medicare.  Medicare does not pay for screening tests, except for certain specifically approved procedures, and may not pay for non-FDA-approved tests or those tests considered experimental.
  • If there is reason to believe that Medicare will not pay for a test, the patient should be informed.  The patient should sign an Advance Beneficiary Notice (ABN) to indicate that he or she is responsible for the cost of the test if Medicare denies payment.
  • The ordering physician should provide an ICD-9 diagnosis code, not a narrative description.
  • Organ- or disease-oriented panels can be billed only when all components of the panel are medically necessary.
  • Both Deaconess Hospital and any other reference laboratory customized panels should be billed to Medicare only when every component of the customized panel is medically necessary.

Panels

Deaconess Hospital Laboratory offers groups of tests based on accepted clinical practice, as well as those that are defined by the American Medical Association Current Procedural Terminology (CPT). All components of these "panels" may be also be ordered individually, unless otherwise indicated.

Referral Testing

Deaconess Hospital Laboratory provides a house test menu of over 1,500 tests and test combinations by selecting primary vendors to perform tests not performed at our laboratory. Primary vendors are selected based upon aspects of service, quality, reliability, turnaround time and price. We reserve the right to change vendors, test parameters and charges for referral testing at any time. For questions please contact Deaconess Hospital Laboratory at 812/450-3345.

Reporting

Autofax - Electronic transfer of test results are provided through Deaconess Regional Laboratory to a dedicated fax.

Electronic Reports - Electronic Transfer of test results allow for immediate availability as soon as Deaconess Regional Laboratory reports results. For offices that utilize an electronic medical record (EMR), results interface directly to the EMR.

Mailed Reports - If faxed or electronic reports are not an option, reports are mailed.

Stat Testing

Inpatients - Refer to Laboratory Turn-Around Time Schedule.
Outpatients - Contact Deaconess Regional Laboratory at 812/450-2740 for availability

 

Supply Orders

Collection supplies and forms are provided for the collection and transfer of laboratory specimens. The Client Supply Requisition is available online.

Amended Reports

In the event that a test result has been reported incorrectly, an amended report is generated. The newly generated report denotes the corrected value and what the test value was reported previously. Amended reports are available immediately.

Billing

Each month an itemized invoice / statement is generated, indicating the date of service, patient name, CPT code, test name and test charge. When making a payment please include the invoice number on your check.

Deaconess Hospital prepares patient bills. The following information is required:

  • Patient name
  • Current address
  • Zip code
  • Telephone number
  • Social Security number
  • patient billing information
  • diagnosis code

Please advise your patients that they will receive a bill for laboratory services from Deaconess Hospital.

Billing - CPT Coding

It is your responsibility to determine the correct CPT codes to use for your billing. Our Lab Test Directory may serve as a guide. The CPT codes listed reflect our interpretation of CPT codes and requirements. In the case of a test involving several component test, the guide provides a comprehensive list of CPT codes for all possible components of the tests. Deaconess Regional Laboratory is not responsible for billing errors due to reliance on the CPT codes provided in the Lab Test Directory. For detailed assistance, please consult the CPT Coding Manual published by the AMA. If you have questions regarding the use of a code, please contact your Medicare carrier.

Alphabetical Test List Description

Information about specific tests can be found in the alphabetical test listing of the User's Guide. The alphabetical test list contains test numbers, mnemonics; methodologies performed/reported, specimen required, reference interval, interpretive data, CPT codes and notes.

Animal Specimens

Deaconess Hospital Laboratory does not accept animal specimens for laboratory testing.

Computer Downtime

Inpatients

Hospital Information System (HIS)
Nursing units will be responsible for placing orders on the “Manual Entry Form” and sending them to Lab. Refer to P&P 10-14 “Invision Downtime Emergency Operational Procedure” for specific detailed information. Manual requisitions will be filled out via the information on these forms. For STAT orders, please call the laboratory. The manual form either will be picked up by the phlebotomist at the time of collection or should accompany the tubes of blood for those nursing units that collect the specimens. During downtime, Laboratory results will be reported on paper requisitions and sent via the tube system to the appropriate unit. Please check your tube station for reports. The Laboratory will have access to previous test results but will be limited on current results during the downtime. The Laboratory is responsible for entering all lab orders received during the downtime.

Outpatients
Please note that during periods of extended computer downtime some delay with result reporting may occur.

Lab Information System (LIS)
If the LIS is inoperable for a length of time, an announcement will be made over the house paging system. The Laboratory will use paper requisitions for the tests ordered by the HIS. The results will be reported on these paper requisitions and sent, via the tube system, to the appropriate unit. Please check your tube station for reports. The Laboratory will have limited access to previous or current test results during a downtime. Please note that if the HIS is operational, previously performed lab tests will be viewable.

Anatomic Pathology
Template reports are available if the downtime is extended. Pap smears may be held up to a day before downtime protocol is implemented. Refer to the Anatomic Pathology Downtime Policy, located in the Histology and Cytology Procedure Manuals.

Test Turnaround Time

Expected analytical turnaround times may be found in the test listing section of this User's Guide. Certain tests may take additional time.

Cancellation of Tests

Cancellations received prior to test analysis will be honored at no charge. Cancellation request received after analysis may not be honored. A report is issued automatically and charged appropriately.

Confidentiality of Results

Deaconess Hospital Laboratory and Deaconess Regional Laboratory are committed to maintaining the confidentiality of patient information. To ensure HIPPA compliance, the following policies have been adopted:

Telephone inquiries: Prior to releasing results to a patient, an authorization for medical release must be signed by the patient. Unless noted on the medical release, results will only be released to the patient.

Facsimiles
: All faxed laboratory reports are sent with a cover page explaining our confidentiality policies, noting that the material being sent is confidential. Contact information and instructions are provided to the recipient in case of transmittal error.

HIV Screening

The State of Indiana law for HIV screening (IC 16-41-6-1) states that a person may not perform a screening or confirmatory test for the antibody to HIV without the written consent of the individual to be tested or a representative. For physician practices that collect their own blood samples, Deaconess Regional Laboratory requires that the consent be obtained at the time of sample collections and that the consent be kept on location as part of the patient's medical record. By sending DRL a sample and order for an HIV screening the physician's office is acknowledging to DRL that a consent has been obtained and is being kept as part of the patient medical record. As a result, it is not necessary to send a copy of the consent to DRL along with the sample. If the need arises, DRL may request a copy of the signed consent.

 

Informed Consent Certification

Submission of an order for any tests contained in this User Guide constitutes the certification by the ordering physician that:

  • The physician has obtained the "Informed Consent" as required by any applicable state or federal laws with respect to each test ordered.
  • Patient authorization has been obtained permitting Deaconess Regional Laboratory to report the results of each test ordered directly to the physician.

Critical Values

Critical Values are defined by the Department of Pathology.

Patient Identification Accuracy

The proper identification of patient specimens is strictly adhered to for quality patient care and safety. The College of American Pathologist Laboratory Checklist Commentary GEN 40700 specifies the need for proper identification; "Specimens lacking proper identification or accompanying requisition will not be accepted."

Compliance requires that the same demographic information be properly labeled on the requisition. If a discrepancy has been identified upon receipt of the specimen, we will notify you and reconcile the discrepancy. Specimens with limited or no identification will be rejected.

Reference Ranges

Deaconess Hospital Laboratory strives to provide clear, unambiguous reference intervals.  For example, an age group listed, as 0 to 2 years should be used for all subjects from birth up to their third birthday.  When reference values have been obtained from the literature, Deaconess Hospital Laboratory conducts validation testing to confirm the range.  Deaconess Hospital Laboratory may revise the literature-provided age groups in order to conform to our standard style.

Specimen Rejection

All specimens are unique in their testing requirements. To avoid specimen rejection or delayed turnaround time, check the specimen required field within each test. You will be notified of rejection or problems on receipt.

Please review the following requirements prior to submitting a specimen to Deaconess Regional Laboratory:

  • Full 24 hour for time urine collection
  • Lack of hemolysis
  • Specimen type (plasma, serum, whole blood, etc.)
  • Specimen volume
  • Patient information requested
  • Patient/specimen properly identified
  • Specimen container (metal-free, separation gel, appropriate preservative, etc.)
  • Transport medium
  • Temperature (ambient, frozen, refrigerated)

Specimen Transport

Deaconess Hospital inpatient specimens should be transported to the laboratory soon after collection or within one hour to facilitate testing. Many specimens may shipped in the pneumatic tube system. Please refer to instructions at pneumatic tube systems for acceptable specimens and packing/shipping instructions.

Deaconess Regional Laboratory specimens are stored at ambient, refrigerated, or frozen temperatures at the client's office until transported by a courier.