Test Selection: i-STAT

We have been set up with individual test selection since before I started in POC (13+ years). Each test has a unique service code assigned along with the appropriate CPT code. The only combo we have is blood gas. When I started, I did not understand why it was set up this way, but it does make sense, especially if all of your testing is on one cartridge. Unfortunately, we utilize multiple ones including the Chem8. Each analyte is also billed individually.

We use test selection through ISTAT DE in Telcor.  We have it set up the same as Debra described above.

So,

For example: if you all use CHEM8+, and a iCA + K is selected, you all have test for that built in LIS, and then a test built for possibly K + Glu and etc....? Our LIS team is saying we need to build every type of test combo selection that could occur  in a cartridge in order for billing to accurate! This seems like a huge task.

Ahh  - so what we do for the Chem 8 cartridge is there is 1 order built - a POC BMP.  When resulted, whichever analytes are present, then the charging drops for those.  We have all our analytes selected to run so this isn't an issue for us, but if we wanted to do just K and Glu, then the order would still create as a POC BMP but then it would only have 2 results on it and 2 charges drop.  It's doable that way, but does look confusing to the end users as they are expecting an entire BMP.

We have one floor location that has the ability to test select. The only tests they can select are iCa or NA from the CG8 cartridge. If they select other components it will hold in the middleware (RALS). If they need the full panel, they will need to select all, If they select another individual test, for example they select only glucose, it will flag in the middleware and wont upload because it is not built single. Is this for one specific location, if so, perhaps review what the need is truly and work with your middleware to create a rule to hold if needed.

Thank you for your answers. Unfortunately, this one unit agreed to have certain selections be available to them, we did a whole project and let them know, "Hey, these are selections that will work, anything else will be improperly resulted/billed". Now they are doing outside of this and I am receiving requests from all types of people in the department based on how certain doctors are feeling that day I suppose. Unfortunately, they are throwing "for patient care at us, because main lab is not fast enough." It seems it doesn't really matter if results are being held in our middleware as they just document as a note in the EMR and move on with their day.  I will bring this up to our medical director and recommend we shut this ability off for them until we can come up with a cohesive agreement and or/can get the LIS team to figure out how to meet their needs without creating 100+ test combinations to accommodate how they may feel one day vs another! Thanks