WELCOME TO UCSD LABORATORY SERVICES GUIDE  
cms.ucsd.edu/labref/default.asp
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REQUISITION AND ORDER/ENTRY INFORMATION for SPEC. PROCESS/PHLEBOTOMY


All outpatient and referral specimens must be accompanied by a fully completed laboratory requisition which
has the requested tests clearly indicated.  If stat or routine is not indicated, test(s) will be performed as routine.
 
The requisition must include: 
     Patient's name
     Medical record number
     Current patient number
     Diagnosis
     Name and ID number of the requesting physician
     Date and time of sample collection
 
The requisition must contain the current patient location at the time the tests are requested. 
Please use standard established clinic acronyms.  To establish or change a clinic acronym with the laboratory,
contact Pamela Sparks at 543-5848.  
 
Fax protocol for Hillcrest-based outpatient Phlebotomy Services  
     Fax machines are available, for the convenience of our customers, in both the ACC Blood Drawing Room
     and the OPC Blood Drawing Room (near Emergency Department).
     ACC Blood Drawing Room fax: 543-6595           OPC Blood Drawing Room fax:  543-5453
    We intend for this fax protocol to improve our level of service to your patients because all required
     information will be available before your patients arrive for phlebotomy.  A completed laboratory
     requisition may be faxed to either blood drawing  room whenever:
          1)  The patient is not physically in the clinic and able to transport written orders.
          2)  The existing computer-based order entry system cannot be used (future orders). 
                (fax should not be used in lieu of order entry system) verbal orders will not be accepted.
 
A faxed requisition will be accepted when the following information (printed or typed) is on the form:
     1) Patients full name (last name first), medical record number and current patient number.
     2) Ordering physicians name and UCSD physician ID number (PID).  Physicians telephone number or
          pager number, address for  referring physicians.
     3) Clinic location (source).
     4) Patient diagnosis or symptoms (icd-9 code).
     5) Tests are clearly identified and marked either stat or routine.
     6) Sample type (blood, urine, peak/trough etc.) Is indicated.
     7) Fax cover sheet is used which clearly states: name of sender and phone number.
 
Send the fax to the blood drawing room where you expect the patient to present.  Adherence to this fax
protocol will allow thelaboratory staff to obtain the correct specimens, perform the testing, and
report results in a timely and efficient manner withoutdelay and inconvenience to patients of UCSD Health Care.
 
Stat Charge Policy:
   Medicare does not recognize so-called "stat charges" (i.e. additional charges levied to cover the extra
   expense associated with performing a stat test). Thus, the UCSD Medical Center does not bill medicare
   for "stat charges."
 
Reflex Testing Policy:
   In order to provide necessary information for patient care, additional testing may be required when
   indicated by the results of an initial, ordered test.  Such reflex testing is minimized and
    performed by the UCSD Medical Center Laboratories only when warranted.  For example,
   further testing to identify specific drugs would be indicated by a positive drug  screen. 
   All reflex  testing will be billed in addition to the initial, ordered test in accordance
   with proper billing practices.  Information about reflex testing may be found in this on-line lab
   user's guide for each specific test or in the current annual physician notice.
   Providers who perfer reflex testing not be performed may contact the laboratory.
   Only tests that are medically necessary for the diagnosis and treatment of a patient should be
   ordered.  Medicare pays only for testing to treat or diagnose a patient. 
   A patient condition that requires ordering test(s)must be documented in the medical record and
   corresponding ICD-9 code(s) must be noted on lab requisitions. 
   Medicare generally does not cover routine screening tests.
 
All services outlined in this laboratory reference guide will be provided to the skilled nursing facility/
 subacute unit utilizing the policies and procedures as contained herein.
 
 
Add-on test request policy:        
  The purpose of this policy is to ensure that "add-on" requests for clinical laboratory tests are             
  properly documented in writing in accordance with medicare, medicaid and other federally funded         
  payor guide lines.  A standardized laboratory requisition form will be utilized to "add-on" any
 additional clinical laboratory tests and must include the following elements:
                    1.  Ordering physician name, PID# and phone/pager number
                    2.  Patient demographics (addressograph stamp)
                    3.  ICD-9 code or diagnosis
                    4.  Additional test(s) requested
                    5.  Current date and time specimen added
                    6.  Indicate if it is a stat or routine request
                    7.  Date and time of initial specimen collection
 
Standing Order Policy: 
  This policy establishes a protocol to ensure the consistent use of standing orders.
  A standing order directs the laboratory to perform that particular test(s) at specified intervals for
  a defined time period without having to get a new requisition form each time.
  Verbal standing orders are unacceptable.  Standing orders must be renewed in  writing every
  6 months and must be submitted to the blood drawing rooms on the standing order requisition form
  with all required information completed.