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Test Code SEE NOTE Pre-Auth/Prior Authorization Guidance for Lab Staff

Important Note

If a patient presents to the laboratory for a blood draw and has an order that is marked with a red X, indicating that it is not authorized, please follow the below guidance. 

  • If the test is a built (e.g., NOT a miscellaneous test/ Lab4300) test in Epic and flags as needing authorization, authorization is required. Call the STAT auth line 208-625-5495 if the patient is there.
    • Examples include: Jak2, BCR/ABL, celiac cascade, pancreatic elastase
  • For Miscellaneous Tests:
    • If the test is a genetic/molecular test, authorization is likely required. Call the STAT auth line and provide the CPT and performing lab information.
      • These tests will often require whole blood as the specimen type. 
    • If the test is a serum/plasma/urine test, authorization is most likely not required. Proceed with specimen collection. 
      • Examples: PT217, urine myoglobin, testosterone
  • For kit tests going to Natera or Myriad Genetics, all prior authorizations are taken care of by the performing laboratory, and authorization by KH is not required. 
     
  • Patients with Medicare insurance do not require pre-auth for lab testing. Any Medicare Advantage plans or supplemental insurance will require pre-auth. 

For any questions, please consult the Ordering Questions chat in Microsoft Teams.