Test Requisition:
All specimens must be submitted with a paper/printed test requisition. This may be a manual requisition or a requisition generated from an office/hospital EHR order system/interface. The requisition must include:

1. Patient demographics: complete patient name, date of birth, sex, Social Security number or medical record number.
2. Complete billing instructions and insurance information; include copies of insurance cards if this information is not provided on the requisition.
3. Ordering provider’s complete name; note that Pathology Medical Services will accept specimens from licensed health care providers only.
4. Place of service/patient status: physician office, hospital in-patient, hospital out-patient.
5. Test order(s), ICD code(s) and clinical information/history.
6. Specimen source/body site/procedure used for specimen collection.
7. Date and time of specimen collection.
8. Time the specimen was placed into formalin.
9. Include Advanced Beneficiary Notice (ABN) as indicated.

Specimen Labeling:
All specimens must be completely and adequately labeled to ensure accurate patient identification.

1. Each specimen container label must include 2-unique patient identifiers (i.e. the complete patient name, DOB, medical record number, SSN or requisition number).
2. Slides must be labeled with 2-unique patient identifiers (i.e. the complete patient name, DOB, medical record number, SSN, or requisition number). If slides are obtained from multiple body sites, the specific body site must be included on each slide label.
3. For multi-part specimens, label each container with the letter part (A, B, etc.) and body site that corresponds to the letter and body site listed on the requisition.
4. Specimens are considered mislabeled when there is a mismatch between the patient identifiers on the specimen and the requisition submitted with the specimen. Mislabeled and completely unlabeled specimens or specimens with only one unique identifier will be returned to the client office.

Specimen Submission:
Specimen containers and requisitions should be submitted in biohazard specimen bags.

1. Submit specimen(s) from one patient per specimen bag.
2. Place specimen container(s) into specimen bag.
3. Place prepared slides into a cardboard or plastic slide holder and place slide holder into specimen bag.
4. Place requisition in the side pocket of the specimen bag.

Verbal Order Authorization/Test Request:
Federal and state regulations require that a verbal request for laboratory testing be documented with a written verification of the request including the signature of the ordering clinician. A Verbal Order Authorization form will be faxed to the client office when a verbal test request is placed. The test order will be processed upon receipt of a signed Verbal Order Authorization.