YNHH Laboratory Manual

Ordering certain tests may result in the performance of additional tests. In some instances, this may happen automatically, as in the performance of volume measurements on all timed urine specimens, or in the quantitation of both a parent drug and its active metabolite (e.g., procainamide and N-acetylprocainamide). Such tests are considered as part of the requested analysis. In other instances, additional testing is performed selectively, based on the results of the initial tests. Examples of this would be identification of an organism detected by blood culture, performance of immunoelectrophoresis to identify a monoclonal band newly discovered on electrophoresis, or confirmation of a positive result of drug abuse screening. Reflex testing of this type will result in additional charges when the testing is performed. This type of reflex testing is only done in circumstances in which the follow up test is almost invariably medically indicated (or legally required, in the case of drug abuse testing). Test descriptions in this manual indicate those tests that may engender reflex testing. If you believe that such reflex testing is not indicated for your patient, please notify the laboratory when ordering the test.

Manual differentials are added (reflexively) if NO previous manual differential was performed, AND a CBC with automated differential showed significant hematological abnormalities.

Updated: July-2008