Ask the Expert
Barry Craig, MLT (NCA), CLC
Lab Coordinator, CHS
Member POCCA (Point of Care Coordinators Alabama)
Member Helena Laboratories Focus Group
I
am a primary care physician with a
small in house lab. My reimbursements
continue to fall and it is getting
harder to perform testing and stay
“in the black.” Do you have any
recommendations?
I hear this lot. With the added burdens
and decline in payments related to
ObamaCare, the laboratory is suffering.
One thing you can do is look at
alternative testing.
As an example, most offices check blood
sugar levels on a Waived meter approved for
home use. This type of glucose testing does
not reimburse much at all.
However, this is one meter out there that uses
a different methodology and is more accurate
so it is allotted a different billing code that
reimburses much better. The same is true for
occult blood testing. The standard guaiac fecal
occult blood test pays a very minimal $3.50 to
$4.50. However the iFOB occult blood test
reimburses around $21.58. This higher specificity
methodology is different from the old methods,
and hence, it pays more. This technology is
available from several manufacturers.
These are only two examples and there are
many more. Lab testing today has evolved, so
you may not only see the benefit of higher
reimbursements for some tests but also more
accurate results as well.
Does the lab inspection include fire and
electrical hazard checks? I think our lab
may have too many devices plugged into
one outlet, etc.
This answer is… maybe. (I should be in
politics) The CLIA lab inspection only checks for
the items listed in the Federal Register as it
relates to CLIA. Items that are OSHA related,
such as what you mentioned, do not fall under
your inspector’s jurisdiction. That being said, if
a CLIA inspector finds evidence of ANYTHING
they believe compromises a patient or
employees health or safety, they can notify the
proper government agency. For instance, if
they observed that safety needles were not
being utilized, they could notify OSHA which
would result in an unannounced inspection.
And now, the top three funniest,
craziest, and weirdest things I have ever
witnessed or heard of at a lab inspection.
1. I attended an inspection of a lab that
stored their reagents, calibrators, etc. in a
dedicated refrigerator in the lab. They did not
utilize the upper freezer unit, just the
refrigerator. They had signage indicating “for
lab use only”, “biohazard” and “keep out”.
I checked the refrigerator and freezer prior
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