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.
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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
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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
- 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.
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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.