Dear Colleagues:
During recent internal audits, we discovered that we need to improve the way we order Pathology and Radiology exams from ambulatory service lines. Quite simply, many of our orders are incomplete, and this has a potentially significant effect on the care we deliver and billing compliance.
Specifically, requisitions and orders arrive in the clinical laboratory and Radiology without the physicians’ name or ID code, a signature from the requesting physician, physician assistant or nurse practitioner, or the appropriate diagnostic code or codes (ICD-9 code). We have implemented a hard stop policy for incomplete requisitions for lab tests, pathology samples and imaging. Effective Aug. 15, no clinical lab testing will be performed when accompanied by a requisition that does not include the signature of the ordering physician, NP or PA, ICD-9 code(s) and a legible clinician code. A similar hard stop will be implemented for Radiology and non-invasive cardiology (echocardiography, vascular lab, cardiac stress lab) test ordering in September. (For more details, see page 3.)
Hospital and PO leadership, along with departmental leaders from Pathology and Radiology, worked with Billing Compliance to come up with a simple and basic solution to this potential problem. Vigilance on the part of the ordering clinician on the front end of this process ensures the appropriate tests are ordered and completed. This process is necessary for us to interpret the results accurately and swiftly in order to incorporate them into the plan of care.
In addition to asking for your vigilance, we’re asking our practice managers and support staff to review Pathology and Radiology orders and requisitions before submitting them. A practice-based team approach of checking and double checking orders before submitting them is a simple fix to a potentially complicated issue.
Thank you for your continued cooperation to this process.
Sincerely,
Steven Seltzer, MD
Chairman, BWPO