New chemistry panels approved by HCFA
Home care nurses will have something new to worry about whenever they draw blood for a laboratory test after Jan. 1, 1998.
The old way of doing things is changing because the Health Care Financing Administra tion (HCFA) has decided it was too wasteful and added to increased medical costs.
Now, each time a physician orders a lab test, he or she will have to include a medical code, commonly called an ICD-9 diagnostic code, or a written diagnosis for each chemical (anolyte) analyzed.
There are only four panels that HCFA will exclude from this requirement. An expert from the Medical Laboratories of Virginia in Fredericksburg offers these brief descriptions of each of those panels:
• Basic Metabolic Panel.
This panel may be ordered for diseases affecting the metabolism, including diabetes, says Paul Hine, MD, medical director of Medical Laboratories of Virginia. The anolytes tested are: carbon dioxide (bicarbonate), chloride, creatinine, glucose, potassium, sodium, and urea nitrogen.
• Comprehensive Metabolic Panel.
This panel may be ordered for a similar reason as the basic metabolic panel, but it also includes a few tests that measure liver function. "It includes tests that could be used for patients who are malnourished or have suspected renal disease or liver disease," Hine says. This panel tests the following anolytes: albumin, bilirubin (total), BUN, calcium, chloride, creatinine, glucose, phosphatase (alkaline), potassium, protein (total), sodium, and transferase (aspartate amino).
• Electrolyte Panel.
Hine says this panel is used for patients who have had a lot of fluid loss, such as chronic diarrhea or vomiting. The anolytes tested are: carbon dioxide (bicarbonate), chloride, potassium, and sodium.
• Hepatic Function Panel.
These anolytes help physicians determine whether a patient has a liver disease. They include: albumin, bilirubin (total and direct), phosphatase (alkaline), transferase (aspar tate amino), and transferase (alanine amino).
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