Lab Management Flashcards
What law setup lab complexity testing levels?
Test levels?
Waived?
Provider performed microscopy does it need proficiency testing?
Moderate/high proficency?
How often inspected?
CLIA-88
Waived: Simple, manfacture procedure, document training
PPM: Simple and does not
Moderate: PT 3x/yr with 5 samples, if no PT must hae meth to assess performance 2x/yr
Inspection every 2 years
Joint inspection of hospitals every how many years?
How often for labs?
CAP inspect every few years?
Phase 2 vs Phase 1?
3 years but unannounced
2 years; can hand this off to deemed organizations
2 years
Phase 2: serious, must document corrective action
Phase 1: minor, correct if possible
CAP inspector’s paid or volunteer?
Do they do PT?
Mainly volunteer; team leader is pathologist
Yes!
What is COLA?
Who do they inspect?
Commission on laboratory accrediation
Most small physicaians offices; simpler checklists than CAP
Requirements to be lab director?
How many labs can you direct?
If high complexity or >500k tests/yr, MD/DP/DPM with 1 yr lab training or 2 years experience directing HC lab; PHD with board certification
If moderate <500k/yr, MD with 20 hrs training of 1 yr experience; PHD with board cert 1 yr; if waived <500k/yr only degree required
5 labs aka 5 CLIA #s
Who is the only person who can write new and revised procedures?
Who can do waived testing?
High complexity?
Mod complexity?
LAB DIRECTOR; cannot be delegated
Waived: Anyone
High: at least asociate degreee in lab science or have been doing it prior to 4/24/95
Mod: At least associate in lab science or high school degree with military or equivalent civilian testing
Is histololgy covered by CLIA?
T/F labs must document training of employees prior to performing patient testing?
No; but many procedure in the histo lab are high complexity (processing, grossing, FISH, IHC)
T; also, need yearly cert of familiarity with contents of procedure manuals
How often to test competency of lab personal?
CMS requires how many components for competency testing?
6 months for new hires, yearly for others
6/ most common CAP/CMS deficiency
Direct observe testing, maintenance, monitoring of result recording, review tst/maintenance records, practical exam, problem solving skills
NEEDS TO BE DONE FOR EACH “SYSTEM”
T/F: Labs must evaluate all sections of the lab and the 3 phases?
What is preanalytic, can room number be a patient ID?
Do you need written collection manuals?
T
Entry of orders, smaple ID, and transport, Joint commission requires 2 patient ID’s; ROOM NUMBER CANNOT BE ONE
YES!
How often do procedures need to be reviewed?
If you have critial values what must you document?
Every 2 years by director or someone delegated by the lab
That you contacted clinical team and read back results
How long to retain CP reports, QC records, blocks per CLIA?
Cytology slides?
AP slides, reports?
2 years
Cytology slides: 5 years
AP: 10 years, CAP: 10 years for blocks as well
How long for blood bank record retention, QC?
What about deferred donors?
Forensic reports/blocks/slides?
Records 10 years, QC: 5 yrs
Deferred donors: Indefinitely
Forensic: Indefinitely
What are examples of indirect costs?
What are fixed costs?
Variable costs?
Space, utilities, management/admin; does not depend on test volume
Fixed: Equipment, qc, calibration, as test volume goes up costs go down
Staff, reagents; costs may lower as volume increases (volume discount)
Know breakeven equation?
Capitated, fee for service, DRG?
Fee for service under Medicare part?
Sendout cost * #tests=Fixed+ Cost *#test
Capitated; Fixed payment per covered member
FFS: specific bill for each test
DRG: fixed payment for disease regardless of length stay; Medicare inpatient
Part B
What is compliance?
Bundling and unbundling?
Self-policing; Should check for correct CPT codes
Unbundling (billing for tests seperately that should be billed as panel)
Bundling (addinging tests not approved for panel to a panel that DOCTORS MUST ORDER)
