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  • 1.  LIS Build

    Posted 8 days ago

    Hello all, 

    My hospital is building a new lab information system to replace an antiquated system. I have the task of ensuring all the microbiology charges are correct. Is it standard practice to build the following charges?

    Seperate charge for each applicable specimen Gram stain.

    Biochemicals such as catalase and oxidase used during culture workup.

    Any reference would be greatly appreciated. 

    Kind regards, 



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    Alicia Lyons Technologist/Scientist, non-supervisor (CT,MLS,MT)
    Bowie MD
    2402649084
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  • 2.  RE: LIS Build

    Posted 7 days ago

    You should be working with this in conjunction with your billing department. They should have a superbill and a system in place for everything they charge for already. No need for you to reinvent the wheel. You should simply be transferring information from one system to the next at this point. If this is something you were charging for previously and should have been charging for, and want to make sure it is added to this new platform, your billing team should be able to help you with that. This way, you can make sure you have the correct CPT codes and diagnosis codes.



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    Lakingya Robinson Supervisor/Lead Med Lab Scientist/MedTechnologist
    Nashville TN
    (773) 368-1570
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    Original Message


  • 3.  RE: LIS Build

    Posted 7 days ago

    Thanks for your response.  There were staffing changes in the billing team so lab leaders were tasked with auditing billable test. 

    I have to confirm the charges are appropriate for migration into the new LIS, pending final finance/compliance approval.

    I reviewed the current charges against our active test menu however, the LIS build team noticed several test that required updates.

    The gray area is charging for different Gram stains, such as routine culture versus CSF, and the charging of biochemicals. These charges are not listed in my current billing list so I want  input on whether they are usually charged seperately.



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    ALICIA LYONS
    MICROBIOLOGY LAB MANAGER
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    Original Message


  • 4.  RE: LIS Build

    Posted 7 days ago
    Edited by Helen Risser 7 days ago

    I work at a hospital which currently has microbiologists input billing as well. I'm cautiously optimistic that we'll automate it during our own LIS switch. Here is how we do things:

    Gram Staining:

    • Most cultures come with an initial Gram stain of the specimen submitted, at no extra charge.
    • For cultures which don't have that automatic stain (for example, we don't do a Gram stain on genital swabs), a provider has to contact us if they want a Gram stain done. This request is considered a separate order and billed apart from the culture.
    • Colony Gram stains performed during the workup of a culture are not charged by themselves BUT...

    Biochemical Testing:

    • We divide our tests into "presumptive ID" and "definitive ID". Biochemical testing, colony morphology, colony Gram stains, wet mounts, growth on selective media, etc. are presumptive. MALDI-TOF, Vitek ID cards, PCR panels, Strep latex agglutination, and send-outs to reference labs are definitive.
    • We charge per organism identification, and consider 4 presumptive tests equivalent to one definitive ID test.
    • Examples:
      • I'm working up a throat culture and see a creamy white colony on sheep blood. I perform a wet mount and see budding yeast. I report "yeast, no further ID" in the provider-facing side of the chart and don't charge for an ID. The colony morphology and the wet mount are only 2 presumptive tests.
      • The provider calls back and requests an ID on the yeast. I run MALDI-TOF and get a result of Candida albicans. I report "C. albicans" to the provider and bill for an ID, since MALDI gives us a definitive ID.
      • I also see a shiny, yellow, beta-hemolytic colony. Gram staining shows Gram positive cocci in clusters. Catalase and coagulase are both positive. The combination of colony morphology, Gram stain, catalase, and coagulase identifies this as Staphylococcus aureus and with 4 presumptive tests, I bill for an ID charge.

    I hope this is helpful!



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    Helen Risser Technologist/Scientist, non-supervisor (CT,MLS,MT)
    Minneapolis MN
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    Original Message