Clinical lab utilization review of highest volume tests recommended by HHS Inspector General.
This article was originally published in The Gray Sheet
Executive Summary
CLINICAL LAB UTILIZATION REVIEW OF HIGHEST VOLUME TESTS RECOMMENDED by the HHS Inspector General in a model compliance plan released Feb. 24. Laboratories should take steps to determine whether physicians are being encouraged to order medically unnecessary tests by tracking the top 30 tests they perform for Medicare beneficiaries and making a "reasonable inquiry" if utilization grows by more than ten percent in a year. Upon request, labs should be able to provide documentation supporting the medical necessity of an ordered service, the document says.