Standing Orders and Serial Diagnostic Tests Revised

NAS is providing the following clarification on the use of “standing orders” for laboratory tests. While Medicare generally requires that lab tests be individually ordered by the treating physician, in some circumstances, recurring orders for a lab test that are specific to the needs of an individual patient may be reimbursable. Automatic, routine or generic standing orders for lab tests, such as those pre-printed for use with patients undergoing a procedure or admission, whether for all such patients or all those treated by a specific practitioner, are not allowed under Medicare. Preprinted or electronic lists of potential orders are permitted if the provider individually affirms, defines, or otherwise modifies each component as appropriate for an individual patient’s clinical circumstances. Reimbursement of each lab test provided under a standing order for a recurring or serial evaluation is subject to medical necessity review. All such orders must be written for a specific patient, and each instance of the test must be necessary. Each result must be reviewed with appropriate action taken by the treating physician including any appropriate change in the frequency or duration of testing.

Source: https://www.noridianmedicare.com