Clinical Laboratory Information Flow

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Questions and Answers

What essential patient demographic information is typically found on a laboratory requisition form?

Patient name, address, phone number, and birth date.

Why is the ICD-9 code important on a laboratory requisition form?

The ICD-9 code indicates the diagnosis or symptom and is necessary for test reimbursement.

What is the purpose of grouping tests into panels or profiles on a requisition?

Panels or profiles indicate problems with specific organ systems or disease processes.

What information must be documented regarding the specimen collection on a laboratory requisition?

Date and time of collection, and identification of the person who performed the collection. Signup and view all the answers

What is the significance of a five-digit procedure code, or CPT code, on a requisition?

The CPT code is necessary for the reimbursement of the laboratory tests. Signup and view all the answers

How can laboratory requisitions help phlebotomists during specimen collection?

Requisitions often include a code or symbol indicating the type of tube or specimen container needed. Signup and view all the answers

What role does a laboratory report play in the information exchange process?

It relays the test results to the health-care provider who ordered the tests. Signup and view all the answers

What additional comments might be included on a requisition form?

Comments may assist with the ordering or interpretation of the test. Signup and view all the answers

What is the purpose of the laboratory directory in specimen collection?

The laboratory directory provides detailed information about tests performed, specimen requirements, processing instructions, and reference ranges. Signup and view all the answers

What specific identifiers must be documented by the employee during specimen collection?

Two unique patient identifiers, employee ID or initials, date, and time of collection must be documented. Signup and view all the answers

Why are reference ranges important in laboratory reports?

Reference ranges indicate expected results in a healthy population and help interpret test outcomes accurately. Signup and view all the answers

What types of information can be included in a laboratory report?

A laboratory report includes test results, reference ranges, patient demographics, and specimen details. Signup and view all the answers

How does the laboratory ensure that specimen collection complies with requirements?

By consulting the laboratory directory for specimen type, volume, processing, and storage instructions. Signup and view all the answers

What is the relevance of documenting a patient's gender and age during the specimen collection process?

Gender and age significantly affect reference ranges and interpretation of test results. Signup and view all the answers

In what ways can laboratory reports be delivered to healthcare providers?

Laboratory reports can be hand-delivered, faxed, mailed, emailed, or accessed online. Signup and view all the answers

What role does the CPT code play in laboratory processes?

The CPT code is used for reimbursement purposes for the tests conducted. Signup and view all the answers

What happens if test results are outside of the expected reference range?

A notation is included on the laboratory report indicating the results outside the reference range. Signup and view all the answers

What is the significance of having both numbers and bar-code symbols on specimen labels?

Numbers and bar-code symbols link the specimen to patient information, ensuring accurate tracking. Signup and view all the answers

Study Notes

Information Flow in Clinical Laboratory

Understanding the organization and information exchange in a clinical laboratory is critical for meaningful test results.
Effective communication involves a laboratory requisition, directory, computer database, and report.

Laboratory Requisition Form

Includes essential patient demographics: name, address, phone number, birth date, and gender.
Collects comprehensive insurance and billing data.
Records date, time of specimen collection, and collector's identification.
Specifies how results should be relayed to healthcare providers.
Requires appropriate ICD-9 diagnostic codes for billing.
Enables test selection marked clearly with check, circle, or X; allows for additional handwritten tests.
Can include panels/profiles for specific organ systems or individual tests.
Groups tests by categories such as hematology, serology, and chemistry.
Each test has a CPT code for reimbursement; requisition includes a symbol for the necessary specimen container.
Often features a peel-off label linking patient info with the specific sample for tracking.

Laboratory Directory

Provides expanded details beyond requisition regarding specimen processing and storage.
Serves as an internal database or printed guide for laboratory tests.
Lists internal test numbers for database entry and CPT codes for reimbursement.
Contains abbreviations and specimen requirements, including volume and tube color.
Details specific collection notes, handling instructions, and storage conditions.
Includes reference ranges and clinical significance for test results.
States intervals/frequency for testing and locations where tests are conducted.

Collection Process

Requires the documenting of two unique patient identifiers, employee ID, date, and time of collection.
The employee may also enter patient data into a database or prepare it for transfer to another location for data entry.

Laboratory Reports

Generated after specimens are tested; lists results with established reference ranges for interpretation.
Reference ranges reflect expected results for healthy individuals, accounting for age, race, gender, and geography.
Includes notations for results outside of normal ranges and factors affecting the interpretation.
Provides essential info: collection date/time, patient ID, laboratory name/address, and specimen source.
Can be delivered via hand, courier, fax, mail, or online access to healthcare providers.
Timely review of results is crucial for effective clinical intervention.
Serves as a legal document integrated into patient health records.

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Description

This quiz examines the information flow within a clinical laboratory and the importance of proper communication during specimen collection, processing, and testing. Understanding the organization of the laboratory and documentation is crucial for meaningful test results to healthcare providers.