General Knowledge Flashcards
What is the type of budget used for the continuous operation of an organization, and the primary budget employed by lab managers?
Operational budget
What is a purchase order that requests that certain supplies be delivered automatically in the number and frequency requested?
standing order
A system of diagnostic codes which identifies a patient’s illness, injury or complaint
ICD-10 codes
Federal reimbursement plan that benefits people over age 65.
Medicare
Which type of budget includes items such as salaries and benefits which are increased or decreased on the basis of the previous year’s budget?
Forecast budget
Which costs change with production volume?
Variable costs
What is a list of descriptive terms and identifying codes for reporting medical services performed by a physician?
CPT codes
What type of error influences values consistently in one direction?
Systematic error
How long must OSHA training records of employees be maintained in the laboratory?
3 years from the date of each training session
According to OSHA, what is the frequency with which gloves should be changed?
When they have been penetrated by blood or other potentially infectious materials.
How soon must Hepatitis B vaccines be offered to new employees?
Within 10 days of employment
How soon must gloves be replaced after contamination
As soon as practical
According to OSHA, who is responsible for writing and monitoring an exposure control plan for the laboratory?
Laboratory safety officer
What are universal precautions in the laboratory?
Assumes all blood and body fluids are contaminated.
When is employee training on blood-borne pathogens required?
At the time of initial employment
What type of budget is associated with government bodies where a fixed amount of money is granted for a fixed amount of time?
Appropriation budget
Budget designed for purchase of equipment, building or remodeling?
Capital budget
What is a flexible budget?
Fixed (overhead) and variable (reagents) are itemized, allowing for changes in test volume.
What type of budget is developed completely new from scratch. Historical info is disregarded. Only the highest ranked items are funded. Used to get rid of dead weight.
Zero-base budget
Which type of budget is prepared quarterly, more accurate than an annual budget
Rolling-Quarter budget
What is a financial tool prepared monthly to anticipate cash flow, rates money is received and spent?
Cash budget
Costs assigned to the production of a product; i.e., a billable test. Reagents, consumables, QC and technical labor.
Direct costs
Costs not directly involved with the billable test. Non-technical labor: phlebotemists, admins, billing, couriers
Indirect costs
What is the difference between cash and revenue?
Revenue is the total amount of income generated. (gross)
Cash flow tracks the amount of cash in hand and the cash flowing in and out of the company. (net?)
Useful for external review, looks at costs in aggregate, uses double entry bookkeeping and generally accepted accounting principles.
Financial Accounting
This type of accounting is useful for internal purposes, less formal rules. Identifies cost on a UNIT basis. Assigns costs to a revenue generating activity.
Cash accounting
Which type of costs are reagents and supplies?
Direct/Variable
Which type of costs are associated with Supervisor time to review QC
Indirect/Variable
Costs that don’t change with test volume; equipment lease, techs needed for coverage, admin overhead
Fixed costs
Direct labor and direct material costs required to produce a billable result. Used to compare different methodologies.
Prime costs
Direct labor and section overhead to produce a billable result. Used to compare cost to measure the same reagent and test volume on two different analyzers.
Conversion costs
Costs required just to keep the laboratory operational. Section and admin overhead, cost to collect and report results.
Ready to serve costs
Cost to produce a billable result, excluding indirect and ready to serve costs.
Full production costs
Formula for full production costs
Prime + Conversion costs
Fully loaded cost formula
Full Production + Ready to serve
Fully loaded cost components
- Prime costs (direct labor and materials)
- Conversion costs (direct labor and section overhead)
- Full production cost (direct labor, direct material, section overhead)
- Ready to serve costs (section OH, collect and report, gen lab OH)
- Fully loaded costs (Prime and ready to serve)
What are Fringe Benefits and how much to they cost?
25-35% of salary
Health insurance
Life and Disability insurance
Retirement
Vacation, sick and maternity leave
Social security tax
How to compute salary costs?
Employee compensation (salary) + Fringe benefits + recruitment + orientation, training and development
50% decrease in workload is what % reduction in FTE?
14%
What are limitations of laboratory cost reduction?
Fully loaded costs have a high percentage of fixed costs. Ex. A 50% decrease in workload results in only a 14% rection in FTE.
Formula for cost to break even
Fixed costs/(test price - variable costs)
Formula for charge to break even
(Fixed costs/test volume) + variable cost
Minimum to break even formula
Fixed cost/(Test price - variable cost) all per unit
Contribution Margin %
(Test Price - Variable cost)/Test Price all per unit
Request to make purchase
Requisition
Order to purchase items at a given price over a given amount of time
Purchase Order
A certain amount of material or total dollar amount that can be ordered within a certain amount of time at a fixed price
Blanket PO
Westgard Rules
Detects both random and systematic errors.
Multi-rule QC
Decision tree shorthand 1 2S (1 control measurement exceeding 2SD of the mean
Levey Jennings Plot
Results on Y axis vs. Time on X axis
Detects trend, shift, dispersion
Sudden failure
Shift
Causes of dispersion
Random errors
Fluctuations
New Tech
Poor mixing
Cumulative Sum Plot
Cusum Plot
Cumulative sum difference from expected values
Determines systematic errors
Gradual loss of reliability
Increase or decrease in one direction
Trend
Reasons could be deterioration of light, materials, accumulation of debris.
Accuracy
Closeness of measured value to true value
Precision
Closeness of repeated measurements
(Repeatability)
Formula for Positive Predictive Value
True Positive/(True Positive + False Positive) x100
Negative Predictive Value Formula
True Negative/(True Negative + False Negative) x100
Sensitivity
True positive rate
(#Diseased Patients with Positive result/Total # Diseased) x100
or
TP/TP+FN x100
False Negative Rate
FN/Total # Diseased
or
1-Sensitivity
False Positive Rate
(FP/Total # Non-diseased) x 100
1-Specificity
Specificity
True Negative Rate
Probability of classifying non-diseased person as non-diseased
(# Non-diseased patients with Negative Result/Total Non-diseased Patients) x100
or
(TN/TN+FP) x100
SNOMED codes
Systemized Nomenclature of Medicine Clinical Terminology
developed by CAP
Used by UK
LOINC codes
Logical Observation Identifier Names and codes
Alternative to CPT
Universal Lab language
7 digit codes
HCPC codes
Healthcare Common Procedure Coding System
Assigned by CMS (not AMA)
Cat II codes - Letter A-V followed by 4 digits
Fill gaps in CPT (where no CPT exists)
CAT III - Temporary set for emerging technologies.
Program administered by states for low-income families
Medicaid
What does Medicare Part A cover?
Hospital inpatient, skilled nursing care, hospice care, home health care
What does Medicare Part B cover?
Laboratory tests, other outpatient services and devices
Used by private insurance to set reimbursement rates.
What does Medicare Part D cover?
Prescription drugs
CPT Modifier 91
Repeat Testing
What is Medicare Part C?
Managed Care Plan (HMO)
Alternative to Part B
CPT Modifier 90
Procedure referred to reference lab
CPT Modifier 59
Distinct procedural services on same day not reported together
CPT Modifier 26
Procedure is a combination of physician and technical component
70-30 Rule
No more than 30% of total testing can be referred out
Room temperature in Celcius
20-24 degrees
Molarity
Moles/Liter
1 mole = gram molecular weight
DOT Hazardous Materials Regulation (HMR)
Category A Substance
Infectious substance capable of causing permanent disability or death to humans or animals
High Risk
DOT Hazardous Materials Regulation (HMR)
Category B Substance
Not capable of causing permanent disability or death
Acronym explaining Six Sigma
DMAC
Define, measure, analyze, improve, control
Formula for Celsius
5/9( F-32)
Formula for Fahrenheit
(9/5)C+32
Formula for Kelvin
C+273
Standard Deviation
Square root of variance:
SD=square root of sum(x-mean)squared/n-1
z score
Standard deviation Index (SDI)
Tells you how many SD a control result is from the mean
Z=(control result - expected mean)/SD
Coefficient of variation
SD divided by mean x 100
UN2814
Category A - affecting humans
UN2900
Category A affecting animals only
UN3373
Category B
95% confidence interval
Within 2SD of mean based on normal distribution
Six Sigma
Quality improvement process
Reducing errors to 3.4 defects per million tests
Six Sigma = 6 SD from the mean in normal distribution
99.9997% confidence interval
