DSI Laboratories


Company Background Compliance Licensures Overview of Services Employment Links	Client Services Billing Client Supply Form Couriers Stat List IT	Overview Technical Bulletins Specimen Requirements Test Menu

It is the policy of DSI Laboratories to provide services in compliance with all state and federal governance for all operations. We strive to be consistent with the highest standards of business and professional ethics. Examples of such policy topics include but are not limited to, patient confidentiality, diagnosis coding, anti-kickback statutes, professional courtesy and medical necessity practices. DSI is committed to compliance with all applicable regulatory agencies including but not limited to CLIA, State of Florida Agency for Health Care Administration, the Centers for Medicare and Medicaid (CMS) and the College of American Pathologists. It is our expectation that organizations and individuals utilizing our services have instituted similar policies to ensure compliance with regulatory requirements. DSI encourages all personnel and clients to contact the Compliance Officer if they have any concerns regarding compliance issues and that all such inquiries or comments will be kept in the strictest confidence possible consistent with the need to investigate all situations.

Health Insurance Portability and Accountability Act (HIPAA)

DSI Laboratories is committed to comply with the Health Insurance Portability and Accountability Act (HIPAA) Privacy, Security and Electronic Transmission Standards. DSI has implemented policies, processes and procedures designed to secure the protected health information (PHI) provided to us by our patients and their providers. Audits are conducted for compliance and effectiveness.

The State of Florida Agency for Health Care Administration limits the information that can be shared directly with patients under Florida Administrative Code 59A-7.000. Laboratory results must be reported directly to the authorized person who has ordered the test. Because the laws of Florida are more strict than those of HIPAA, we are not permitted to release results to patients unless we are instructed to do so by the ordering authority. Other information such as billing data can be released to the patient or designated entity with an appropriate release form. Please contact the Compliance Officer for specific instructions.

DSI Laboratories has a rigorous Quality Assurance program located here in our regional facilities that monitors and audits all instrumentation used in processing the specimens we receive from our clients. All instruments are tested and calibrated on a regular basis to ensure quality results. Spot checks are performed and specimens are re-tested at random intervals to monitor performance.

All DSI Laboratories participate in the College of American Pathologists Proficiency Testing Programs in which unknown samples are analyzed and the results compared to other laboratories in the United States. In addition, each assay contains a minimum of one normal and abnormal control period. All results are correlated and processed daily. If an analyte shows a variation greater than expected for the procedure, the testing system is reviewed and corrective action is taken. A preventative maintenance program is in place to be efficiency of each instrument within the Laboratory.

Inspection programs by the College of American Pathologists consist of a CAP-appointed panel of practicing Pathologists and other laboratory professionals from the state of Florida. Our laboratories have consistently scored well in both proficiency and inspection programs and are fully accredited. All DSI laboratories are also inspected and accredited by the State of Florida.

Audit Functions

DSI Laboratories Compliance Department randomly audits requisitions or orders from all clients. Each requisition or order is monitored for 26 different items to ensure accurate reporting and testing of specimens and the best quality care possible. Some of the items audited are ensuring all necessary information, such as diagnosis or patient information, is on the requisitions or orders and correctly entered into our systems. Other audit items ensure the correct tests are ordered and results are sent to all necessary providers.

Our Compliance area also provides education for all Registration Associates, and works with the Marketing area to provide necessary information for our Clients. The Compliance and Billing areas have worked extensively with our local Medicare Part B provider to ensure we have up to date Medicare Advance Beneficiary Notice information, which is shared with our Clients.

The Compliance area also audits the billing process. In this area, claims are randomly checked to ensure all information gathered at Registration is carried accurately through to the billing process. The billing process is further audited to ensure compliance with Medicare and Medicaid regulations.

Billing processes are carefully monitored to ensure any overpayments are returned promptly to the correct payor either through refund checks or notification to carriers so they can deduct overpayments from future remittances.

Test Orders

All orders must be submitted in writing by a licensed practitioner authorized to order laboratory tests. DSI provides test requisitions which may be preprinted with the client’s name and address and tailored to their practice. Instructions for completion of test requisitions are listed in the General Collection Guidelines section of this manual. There are standard panels and profiles that DSI performs based on AMA approved CPT codes. All reflex testing and additional panels and profiles are outlined in the Test Directory section of this manual which is also available online.

Laboratory Diagnostic Reflex Profiles

Reflex Profiles are tests that provide our clients with a screening test which will automatically generate an order for a confirmatory or additional test(s) according to our established protocol. This ordering convenience eliminates any delays in obtaining additional testing. This list provides the commonly ordered reflex panels offered by our laboratory. In many cases, the profile is the default order. Please refer to the requisition or ordering manual at www.dsilabs.com which identifies and explains all reflex profiles. If you wish to order a test without reflex, please specify these instructions on your order. Reflex testing may incur additional charges for the additional testing.

Test Order #	Diagnostic Panel (With Individual Tests Listed Below)	CPT Code
3502521	Urinalysis Urinalysis with Reflex Microscopic (microscopic performed only if chemstrip is positive) Chemstrip Urinalysis Microscopic Urinalysis	81001* 81003 81015
3502531	Urinalysis Urinalysis with Reflex Microscopic & Culture (microscopic performed only if chemstrip is positive; culture performed if chemstrip or microscopic is positive) Chemstrip Urinalysis Microscopic Urinalysis Urine Culture (Organism Identification / Organism Susceptibility (billed separately at additional charge)	81001* 81003 81015 87086
1008200	Hepatitis B Panel Hepatitis B Virus Surface Antigen, Hepatitis B Core Antibody, Total, and Hepatitis B Surface Antibody with Reflex to Hepatitis B Core Antibody, IgM Hepatitis B Surface Antigen (HbsAg) Hepatitis B Surface Antibody (anti-HBs) Hepatitis B Core Antibody, Total (Combined IgG & IgM) [anti-HBc (Total)]* Hepatitis B Core Antibody, IgM (Acute) [anti-HBc (IgM)] *If anti-HBc Total is 'positive', anti-HBc (IgM) reflex testing is performed to determine whether the patient has "acute" infection with Hepatitis B Virus	87340 86706 86704 86705
5000460	Hepatitis B Surface Antigen Hepatitis B Surface Antigen with Reflex to Hepatitis B Surface Antigen Neutralization Confirmatory Test (Neutralization procedure performed if HBsAg is positive) Hepatitis B Surface Antigen (HbsAg)(cannot be ordered separately) Hepatitis B Surface Antigen Neutralization Confirmatory Test(cannot be ordered separately)	87340 86382
2000880	Sickle Screen Sickle Screen with Reflex Hemoglobin Electrophoresis (Hemoglobin Electrophoresis performed if Sickle Screen is positive) Sickle Screen Hemoglobin Electrophoresis	85660 83020
5000158	Lyme Disease Serology Lyme (IgM/IgG) Antibody with Reflex to Lyme Western Blot (Lyme (IgM/IgG) antibody screen performed with reflex to confirmatory Western Blot testing if screen is positive) Lyme IgM/IgG Antibody Screen by EIA Lyme Western Blot	86618 86617 (x2)
5020019	HIV Serology HIV-1&2 Antibody Screen with Reflex to HIV- Western Blot) (HIV Western Blot confirmation performed if HIV screen is reactive) HIV-1&2 Antibody Screen (EIA) HIV-1 Western Blot	86703 86689

Test Order #	Diagnostic Panel (With Individual Tests Listed Below)	CPT Code
5002013	Neutrophil Cytoplasmic Antibody Neutrophil Cytoplasmic Antibody (ANCA) with Reflex to Myeloperoxidase Antibody, IgG (MPO) , Serine Protease 3 Antibody, IgG (PR3) , Glomerular Basement Membrane IgG (If ANCA by IFA is positive or atypical, MPO and PR3 will be performed) Neutrophil Cytoplasmic Antibody (ANCA) Myeloperoxidase Antibody, IgG (MPO) Serine Protease 3 Antibody, IgG (PR3) GBM IgG	86255 83516 83516
5000760	Syphilis Serology RPR with Reflex to FTA (RPR with reflex to FTA-abs confirmation if RPR is reactive) RPR (cannot be ordered separately) FTA-abs	86592 86781
1001586	Protein Electrophoresis Protein Electrophoresis (Serum & Urine) with Reflex Testing (If initial serum or urine protein Electrophoresis is abnormal, one or more follow-up tests will be performed) Protein Electrophoresis, Serum (PE S) Protein Electrophoresis, Urine (PE U R) Immunofixation, Serum (IFE S) Immunofixation, Urine (IFE U) C-Reactive Protein (CRP) Quantitative Immunoglobulins (QIM: IgG, IgA, IgM) Beta 2 Microglobulin (B2M)	84155, 84165 84156, 84166 86334 86325 86140 82784x3 82232
5002120	ANA Screen, Reflex to Titer by IFA ANA Screen (If initial screen is positive, titer will be performed by IFA methodology.)	86038,86039
5002140	Autoimmune Reflex Panel (If ANA negative, no further testing) ANA Screen automatic reflex testing for ANA pattern and titer by IFA DNA Scleroderma Antibody (ENA-Scl-70) Sjogren Antibody (SSA) Jo-1 Antibody (ENA-Jo-1) Sjogren Antibody (SSB) Histone Antibody Smith Antibody Centromere Antibody Ribonucleic Protein antibody (ENA-RNP) Rheumatoid Arthritis Factor	86038,86039 86225, 86235 x 8 86431
3000601	Platelet Function Screen Platelet Function Screen, (if results greater than 183 sec confirmatory test ordered) Platelet Function Confirmation (cannot be ordered separately)	85572 x 2
6000563	Respiratory Syncytial Virus DFA Smear Reflex to Viral Respiratory Culture RSV DFA Smear (if negative, reflex to Culture) Viral Culture Complete Respiratory	87280 87252,87254
8100215	Liquid Based SurePath/ThinPrep Pap Test Reflex to HPV Thin Layer(SurePath/ThinPrep) Liquid Based Pap Test HPV Screen	88142 87621
0030181	Lupus Anticoagulant Panel with Reflex APTT (If the Partial Thromboplastin Time and Dilute Russell Viper Venom Time are normal, no further testing will be performed. If abnormal, these tests are ordered and performed:) Protime APTT 1:1 Mix (Cannot be ordered separately) Platelet Neutralization (Cannot be ordered separately) Dilute Russell Viper Venom Time (Cannot be ordered separately) Smith Antibody Centromere Antibody Dilute Russell Viper Venom Time Confirmation (Cannot be ordered separately)	85610 85730 85613 If positive add 85735 85613 x 2 85597