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Alverno Laboratories
Clinical Test Bulletins

Important COVID-19 Information

Alverno Laboratories will begin sending Coronavirus (COVID-19) samples to LabCorp for physicians that would like to request Novel Coronavirus (COVID-19) testing on their patients as an alternative to sending to the State Laboratories. Alverno is working to bring Coronavirus testing in-house so we can offer faster turnaround for our patients. On March 4th, the CDC announced the following criteria for testing. Clinicians should use their judgment to determine if a patient has signs and symptoms compatible with COVID-19 and whether the patient should be tested. Decisions on which patients receive testing should be based on the local epidemiology of COVID-19, as well as the clinical course of illness. Most patients with confirmed COVID-19 have developed fever and/or symptoms of acute respiratory illness (e.g., cough, difficulty breathing). Clinicians are strongly encouraged to test for other causes of respiratory illness, including infections such as influenza.

Ordering Information
Provide the following information using your standard process for test requests:
Test Name – COVID-19 #139900

Expected Turnaround Time
3 – 4 days

Specimen
Nasopharyngeal (NP) swabs are preferred. Bronchial washings or bronchoalveolar lavage (BAL) are also accepted. All specimens must be obtained by a physician. Specimens will not be collected at patient service centers.

Volume |  Minimum Volume
1 mL | 0.2 mL

Container
Nasopharyngeal swab in Universal Trans Media (Item # 111005), sterile cup (Item # 153706) .
* Send in separate, clearly marked bag, preferably a purple bag (Item # 161403) *

Storage Instructions
Refrigerate. Samples are stable refrigerated for 72 hours otherwise freeze.

Causes for Rejection
Swabs with calcium alginate or cotton tips; swabs with wooden shafts; refrigerated samples greater than 72 hours old; room temperature specimen submitted; improperly labeled; grossly contaminated; broken or leaking transport device; collection with substances inhibitory to PCR including heparin, hemoglobin, ethanol, EDTA concentrations >0.01M

Dear Healthcare Provider,
The information contained here may be very important to your practice. Please take a moment to review this document.

PAIN MANAGEMENT PANEL UPDATES

COMING ON APRIL 21, 2020
Alverno Laboratories is pleased to announce Pain Management Panel testing will now be conducted in-house on our Liquid Chromatography Mass Spectrometer (LCMS), reducing turnaround time. Alverno’s Pain Management Panel will be more comprehensive, consisting of 79 reported analytes, specimen validity, and an interpretation based on the submitted medication list. Please see page 2 through 4 for details.

MANDATORY PHYSICIAN COMPLIANCE LETTER

March 2020
Medicare Compliance, enforced by the Office of Inspector General (OIG), mandates that an annual written notice be sent to physicians from the Laboratory Compliance Officer addressing certain key compliance-related issues and, therefore, is included in the Alverno Compliance Plan. This notice meets Medicare Compliance education requirements. We ask that you review the full letter shown on pages 5 and 6.

Test Summary

UTILIZATION GUIDES

Pain Management Panel Update

EFFECTIVE APRIL 21, 2020
Alverno Laboratories is pleased to announce Pain Management Panel testing will now be conducted in-house on our Liquid Chromatography Mass Spectrometer (LCMS), reducing turnaround time. Alverno’s Pain Management Panel will be more comprehensive, consisting of 79 reported analytes, specimen validity, and an interpretation based on the submitted medication list. Specimen validity will be evaluated via pH testing, creatinine analysis, and specific gravity. The table below provides more detail of the new panel’s analytes and cutoffs, as well as a comparison to the current panel provided by ARUP. At this time, samples will be batched on Tuesday and Thursday, with the interpretations being completed on Wednesday and Friday. Alverno will provide a new report template, creating a more user-friendly report. Analytes will now be reported with quantitation.



Specimen Requirements

Specimen: Urine, 10mL
Stability: Up to 7 days refrigerated
Method: Liquid Chromatography Mass Spectrometry
Availability: Batched; Tuesday and Thursday
CPT: 80307*

Information regarding Soft order codes and CPT codes* can be found on our website at www.alvernolabs.com or by calling 800-937-5521.

*CPT codes provided are for informational purposes only. Questions regarding coding should be directed to the payer.

Annual Physician Compliance Letter

Dear Physician,
Medicare Compliance, enforced by the Office of Inspector General (OIG), mandates that an annual written notice be sent to physicians from the Laboratory Compliance Officer addressing certain key compliance-related issues and, therefore, is included in the Alverno Compliance Plan. This notice meets Medicare Compliance education requirements.

  • You as the ordering physician and the laboratory are responsible for ensuring the presence of diagnostic information for each test ordered on the laboratory requisition documenting medical necessity (Balanced Budget Act of 1997, Pub 105-3, effective January 1998). This documentation should be in the form of an ICD-10-CM diagnostic code. Please note that all components of Medicare-approved Chemistry Panels must also follow Medical Necessity guidelines as defined by Medicare. The diagnostic information is required to be included in the patient’s medical record for each date of service for Medicare to reimburse you for your patient’s testing.
  • Some tests have published National Coverage Determinations (NCDs) or Local Coverage Determinations (LCDs) that state the ICD-10-CM diagnostic codes that will be covered by the Medicare Program. If there is reason to believe that Medicare will not reimburse the test (e.g., the patient’s condition is not covered in the NCD or LCD), the physician must ask the patient to sign an Advanced Beneficiary Notice of Non-Coverage (ABN) prior to the specimen collection. It is against Medicare regulations to have all Medicare patients sign an ABN (Blanket ABN).

Note: Some private insurance carriers may implement their own Medical Necessity Policies. These insurance carriers will not pay for tests that do not meet their Medical Necessity requirements. You, the physician, will be required to ask the patient to sign an “ABN,” prior to blood collection, if Medical Necessity requirements are not met.

  • If the laboratory receives a test request and a specimen collected by your office personnel with inadequate medical necessity documentation, and the laboratory is unable to bill either Medicare or the patient (e.g., no diagnostic code or ABN signature provided), the physician’s client account will be billed for the laboratory service.
  • The laboratory cannot provide free services to anyone. Write-offs due to lack of required billing information, professional courtesy requests, and other “perks” may be considered by the Office of the Inspector General (OIG) as inducements to the physician by the laboratory and may be subject to scrutiny for fraud and abuse for both parties.
  • PECOS: Medicare strongly encourages all providers to use internet-based PECOS (Provider Enrollment Chain and Ownership System) when revalidating enrollment information, adding a reassignment of benefits, or enrolling in Medicare as a new provider. Note: The provider name for the PECOS enrollment must match exactly the provider name in the NPI system.

While we are obligated to remind you of Medicare’s regulations, we understand the occasional problems that it presents for you, your patients, and the laboratory. By working together, our joint efforts will minimize any inconvenience and ensure that your patients receive the necessary testing for their medical needs and that the laboratory receives appropriate compensation by Medicare.

  • If you have questions concerning the application of the above policies, please contact the Alverno Laboratories Compliance Manager at 219-836-2682, or Alverno Billing Services at 877-937-2190.

Any questions pertaining to this memorandum, or Alverno compliance policies in general, may be addressed to Jack Strzempka, Compliance Officer, at 219-836-2682.

Sincerely,
Jack Strzempka
Compliance Manager