What's New

April 25, 2021

Governor Tom Wolf honors Medical Lab Professionals Week

In honor of #MedicalLabProfessionalsWeek, Governor Tom Wolf issued a proclamation to recognize the vital role of Pennsylvanians in this field - whether on the front lines with patients, in the clinical lab, or across the many operations essential to diagnosing and treating people! Hear what he had to say to our #healthcareheroes

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April 24, 2021

Healthcare Heroes - Know the Facts

#KnowtheFacts - Although 70% of decisions about patient diagnosis and treatment hinge on laboratory test results, testing still represents only three cents of every dollar spent on healthcare in this country.
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April 23, 2021

Meet our HNL Heroes

Meet our #HNLHeroes!

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April 22, 2021

Healthcare Heroes

None of our HNL medical professionals go into this business for notoriety. They do it to get the results that are needed for our community. 
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April 21, 2021

Healthcare Heroes

How has COVID-19 impacted medical lab professionals in the Lehigh Valley? Hear what an HNL lab professional had to say:
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Healthcare Professionals

Medicare Test Frequency Limitations

Medicare Test Frequency Limitations

 
 
Test Name
HNL Lab Medicine Test Code
CPT
Frequency Limitations Descriptions
LIPID PANEL
LIPAN
80061
No more than once a year unless with supporting dx 
VITAMIN C - ASSAY OF ASCORBIC ACID
VITC
82180
Up to 1 times per year without diagnosis limitations applied at this time 
OCCULT BLOOD - screening
OCBSC
82270
Annually.
OCCULT BLOOD - diagnostic
OCCLT
82272
In patients who are taking non-steroidal anti-inflammatory drugs and have a history of gastrointestinal bleeding but no other signs, symptoms, or complaints associated with gastrointestinal blood loss, testing for occult blood may generally be appropriate no more than once every three months.
VITAMIN D; 25 HYDROXY
VTD
82306
Up to 3 times per year with supporting dx 
CARCINOEMBRYONIC ANTIGEN (CEA)
CEA
82378
Serum CEA determinations are generally not indicated more frequently than once per chemotherapy treatment cycle for patients with metastatic solid tumors which express CEA or every two months post-surgical treatment for patients who have had colorectal carcinoma. However, it may be proper to order the test more frequently in certain situations, for example, when there has been a significant change from prior CEA level or a significant change in patient status which could reflect disease progression or recurrence. Testing with a diagnosis of an in situ carcinoma is not reasonably done more frequently than once, unless the result is abnormal, in which case the test may be repeated once.
ASSAY OF CARNITINE
CARN & UCAR
82379
Up to 3 times per year with supporting dx 
CHOLESTEROL
CHOL
82465
No more than every 2 months unless with supporting dx
COLLAGEN NTx X-LINK
CNTXL
82523
Because of significant specimen to specimen collagen crosslink physiologic variability (15-20%), current recommendations for appropriate utilization include: one or two base-line assays from specified urine collections on separate days; followed by a repeat assay about 3 months after starting anti-resorptive therapy; followed by a repeat assay in 12 months after the 3-month assay; and thereafter not more than annually, unless there is a change in therapy in which circumstance an additional test may be indicated 3 months after the initiation of new therapy.
VITAMIN B12
VB12, ANCP2, VB12STAT
82607
Up to 2 times per year with supporting dx 
VITAMIN D; 1, 25 DIHYDROXY
VD1
82652
Up to 2 times per year with supporting dx 
ASSAY OF FOLIC ACID SERUM
FOLATE, ANCP2
82746
Up to 3 times per year with supporting dx 
REAGENT STRIP/BLOOD GLUCOSE
HNL DOES NOT PERFORM
82948
Once per month unless with supporting dx 
GLUCOSE BLOOD TEST
HNL DOES NOT PERFORM
82962
Once per month unless with supporting dx 
GAMMA GT
GGT
82977
When used to assess liver dysfunction secondary to existing non-hepatobiliary disease with no change in signs, symptoms, or treatment, it is generally not necessary to repeat a GGT determination after a normal result has been obtained unless new indications are present. If the GGT is the only “liver” enzyme abnormally high, it is generally not necessary to pursue further evaluation for liver disease for this specific indication. When used to determine if other abnormal enzyme tests reflect liver abnormality rather than other tissue, it generally is not necessary to repeat a GGT more than one time per week.
FRUCTOSAMINE
FRUC
82985
Once per month 
HEMOGLOBIN A1c
HA1CG
83036
Once per month 
ASSAY OF HOMOCYSTEINE
HCYS, CVCP3, HCCP1
83090
Up to 1 times per year with supporting dx 
ASSAY LIPOPROTEIN PLA2
MCHG83698
83698
Up to 1 times per year with supporting dx 
HDL CHOLESTEROL,DIR
HDLD
83718
No more than every 2 months unless with supporting dx 
LDL CHOLESTEROL, DIRECT
LDL
83721
No more than every 2 months unless with supporting dx 
PSA,TOTAL, PROSTATE SPECIFIC ANTIGEN - diagnostic
PSA
84153
Generally, for patients with lower urinary tract signs or symptoms, the test is performed only once per year unless there is a change in the patient’s medical condition. Testing with a diagnosis of in situ carcinoma is not reasonably done more frequently than once, unless the result is abnormal, in which case the test may be repeated once.
ASSAY OF VITAMIN B6
VTB6
84207
Up to 1 times per year with supporting dx 
ASSAY OF VITAMIN B2
VITB2
84252
Up to 1 times per year without diagnosis limitations applied at this time 
ASSAY OF VITAMIN B1
VB1, WBVB1
84425
Up to 1 times per year without diagnosis limitations applied at this time 
T4, THYROXINE; TOTAL
TH7
84436
Up to 4 times per year for most patients,  unless with supporting dx 
T4 FREE, THYROXINE; FREE
FT4
84439
Up to 4 times per year for most patients,  unless with supporting dx 
THYROID STIMULATING HORMONE (TSH)
TSH
84443
Up to 4 times per year for most patients,  unless with supporting dx 
ASSAY OF VITAMIN E
VAECP, VITAE
84446
Up to 1 times per year without diagnosis limitations applied at this time
TRIGLYCERIDE
TRIG
84478
No more than every 2 months unless with supporting dx 
T3, Uptake
T3U
84479
Up to 4 times per year for most patients,  unless with supporting dx 
ASSAY OF VITAMIN A
VAECP, VITAB
84590
Up to 1 times per year without diagnosis limitations applied at this time 
ASSAY OF VITAMIN K
VITK
84597
Up to 1 times per year without diagnosis limitations applied at this time 
BETA HCG, SERUM
BHCGH
84702
It is not reasonable and necessary to perform hCG testing more than once per month for diagnostic purposes. It may be performed as needed for monitoring of patient progress and treatment. Qualitative hCG assays are not appropriate for medically managing patients with known or suspected germ cell neoplasms.
FIBRONOGEN ANTIGEN
?
85385
Up to 3 times per year with supporting dx 
ALLERGEN IGE
Various Codes
86003
CPT code 86003 will be covered for only thirty (30) units in a year.
C-REACTIVE PROTEIN HIGH SENSITIVITY TESTING
HSCRP
86141
It is considered reasonable and necessary to perform no more than 3 hsCRP services per patient lifetime.
HUMAN PAPILLOMAVIRUS
HPV
87624
HPV testing once every five years as an additional preventive service benefit under the Medicare program for asymptomatic beneficiaries aged 30 to 65 years in conjunction with the Pap smear test. (Use ICD-10 code Z12.4 and Z11.51).
GLUCOSE TESTS FOR DIABETIC SCREENING
 
82947
82950
82951
Two screening tests per year for beneficiaries diagnosed with pre-diabetes. One screening test per year if previously tested, but not diagnosed with prediabetes, or if never tested. (Use ICD-10 code Z13.1).
PSA, TOTAL, PROSTATE SPECIFIC ANTIGEN - screening
PSAST
G0103
Annually. All male Medicare beneficiaries aged 50 and older (coverage begins the day after 50th birthday, Z12.5)
PAP SCREEN
N/A
G0123
G0145
P3000
Annually if at high risk for developing cerv or vag CA, or childbearing age with abnormal PAP within past 3 yrs, every 24 months for all other women. (Use ICD-10 codes: High risk – Z77.22, Z77.9, Z91.89, Z72.89, Z72.51, Z72.52, AND Z72.53 / Low risk – Z01.411, Z01.419, Z12.4, Z12.72, Z12.79, and Z12.89).