List of Laboratory Tests/LMRPs*

Here’s the information from the bottom section of the advance beneficiary notice (ABN) form that Liz Kehrer, CHAM, manager of patient access at McHenry, IL-based Centegra Health System, designed for her hospital.

* LMRP = Health Care Financing Administration’s local medical review policy.

Medicare limited-coverage tests. We believe in your case Medicare is likely to deny payment for:

- Allergen-specific IgE sensitivity

- Bacterial culture

- Blood counts (CBC)

- Cytogenetic studies

- Digoxin

- Ferritin

- Gamma glutamyltransferase

- Glucose

- Glycated hemoglobin

- Glycated protein

- Immunoassay for tumor antigen

- Unlisted immunology:

- Alpha-fetoprotein

- CEA

- Gonadotropin

— CA125 Ca27-29

- Iron studies:

— Iron

— IBC

— Transferrin

- Lipid profile

— Cholesterol

— Triglyceride

— HDL, LDL, VLDL

- Magnesium

- Pap Smear:

— Screening

— Diagnostic

- PTT

- Platelet counts

- Prostate-specific AG (PSA)

- Prostatic acid phosphatase

- Protime

- Reticulocyte counts

- Rheumatoid factor test

- Syphilis test

- Thyroid function studies

- Troponin (and/or CK)

- Urine culture

- OTHER (specify):_____________