Health Information Management

Q/A: Signature requirements for lab requisitions

APCs Insider, December 17, 2010

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Q: Laboratory requisitions have never required a signature because they are not orders.
Has something changed?

A: Yes, CMS issued updated guidance concerning laboratory requisitions as part of the Medicare Physician Fee Schedule final rule for CY 2011. Based on discussions with providers, confusion exists regarding the difference between orders and requisitions.

A physician signature/authentication has always been required for orders. CMS defines an order as a communication from the treating physician/practitioner requesting that a diagnostic test be performed. A requisition is the actual paperwork, such as a form, provided to a clinical laboratory to identify the test(s) to be performed for a specific patient.

CMS also has received requests for development of a single policy for all laboratory services and has concerns about reference laboratories’ belief that a test should be performed to protect the viability of a specimen. To eliminate this confusion and provide a standard policy for requesting laboratory tests, a physician/NPP signature is required for all laboratory requisitions effective January 1, 2011.

Editor’s note: Denise Williams, RN, CPC-H, Director of Revenue Integrity Services for Health Revenue Assurance Associates, Inc., in Plantation, FL, answered this question.



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