Annually, we are required to communicate to all physicians for whom we perform customized or standard profiles notice of the constituents of the panels offered (listed below). In addition to these profiles, CMS has approved specific test panels which we have adopted (biochemical profile, lipid profile, electrolyte profile, etc.). Please note that Blue Cross Blue Shield of Michigan (BCBSM) or Medicare may not pay for every test which is ordered and that ordering a profile may result in the ordering of tests for which BCBSM or Medicare may deny payment. Medicare and Blue Cross do not pay for testing when encounters indicate "routine office visit."

When reimbursement is sought, only medically necessary tests for each patient should be ordered. Medical necessity must be determined by the ordering physician and communicated as a diagnostic code. Physicians may choose to order tests individually to avoid having tests that are not medically necessary performed as part of a profile. Physicians may also order a less inclusive profile. When ordering tests, physicians should use one or more diagnostic codes to describe the patient's signs or symptoms. The reason for ordering each test must be documented in the medical record. This is very important.

Senior Professional Staff members within Pathology may be able to help determine which tests are most appropriate for each patient's condition or symptoms. Consulting staff in Pathology may be reached by calling (313) 916 LABS (5227).