Lab Panel Codes

cstarnescstarnes
in GENERAL

Under the introductory section of Organ or Disease-Oriented Panels 3rd paragraph, it is stated, "Do not report 2 or more panel codes that include any of the same constituent tests performed from the same patient collections."  I am seeking clarification as to whether this literally means the same blood specimen collection or if it more generally means the same DOS collection.  There are times in my hospital setting that constituent tests are performed on the same DOS on an OP encounter, so it might lead one to report an appliccable panel code.  However, sometimes the constituents are not ordered at the same time and the tests might be run from separate blood specimens drawn at different times, but still on the same DOS.  Any guidance or references would be appreciated.

Comments

  • dwilliamsrsidwilliamsrsi
    If the panels are drawn at the same time, and have some of the same components, you would report the more comprehensive panel and then the components of the second panel that are not included in the first.  Reporting both panels raises the question of "why is a component ordered and performed at the same time from the same blood draw."  The answer is because the practitioner ordered both panels.  When a panel is repeated at a later time on the same day, it is possible that it would be appropriate, but "why is the full panel medically necessary?  Why can't the components that were out of normal range be repeated rather than the full panel?"  For example, a CMP is ordered and resulted at 9am.  The patient's glucose and sodium are low but the remainder of the components are normal.  The physician treats the low glucose and sodium and wants to recheck the levels at noon.  Medical necessity would be supported for the glucose and sodium levels, but there is no reason to repeat the full panel as albumin, bilirubin, SGPT and SGOT levels typically don't change much in a few hours.  (I have not considered any MUE - using this for example purposes only.)   The question in these scenarios are around the medical necessity of the test and not repeating "unnecessary" tests.  
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