New chemistry panels approved by HCFA
New chemistry panels approved by HCFA
Your nurses need to know about these
Home care nurses will have something new to worry about after Jan. 1, 1998, whenever they draw blood for a laboratory test.
The old way of doing things is changing because the Health Care Financing Administration (HCFA) has decided it was too wasteful and added to increased medical costs.
Now, each time a physician orders a lab test, he or she will have to include a medical code, commonly called an ICD-9 diagnostic code, or a written diagnosis for each chemical (anolyte) analyzed.
There are only four panels that will be excluded from this requirement, and experts from the Medical Laboratories of Virginia offer these brief descriptions of each of those panels:
• Basic Metabolic Panel. This panel may be ordered for a variety of diseases that affect the metabolism, including diabetes, says Paul Hine, MD, medical director of Medical Laboratories of Virginia. The anolytes tested are: carbon dioxide (bicarbonate), chloride, creatinine, glucose, potassium, sodium, urea nitrogen.
• Comprehensive Metabolic Panel. This panel may be ordered for a similar reason as the basic metabolic panel. But it also includes a few tests that measure liver function. "It includes tests that could be used for patients who are malnourished or have suspected renal disease or liver disease," Hine says. This panel tests the following anolytes: albumin, bilirubin (total), BUN, calcium, chloride, creatinine, glucose, phosphatase (alkaline), potassium, protein (total), sodium, and transferase (aspartate amino).
• Electrolyte Panel. Hine says this panel is used for patients who have had a lot of fluid loss, such as chronic diarrhea or vomiting. The anolytes tested are: carbon dioxide (bicarbonate), chloride, potassium, and sodium.
• Hepatic Function Panel. These anolytes will help a physician draw a clearer picture of whether a patient has a liver disease. These include: albumin, bilirubin (total and direct), phosphatase (alkaline), transferase (aspartate amino), and transferase (alanine amino).
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