HOW TO COUNT TESTS
Do not count:
  • Waived tests
  • Proficiency test samples
  • Quality control samples
  • Calculated test results
  • Tests referred to another laboratory
ProcedureHow to Count
All PPM tests Count each specimen as one test.
Urinalysis dipstick (Non-waived)Count as one test, regardless of the number of reagent pads on the test strip.
Urine MicroscopicCount each specimen as one test.
Chemistry Tests and ProfilesCount each test individually, even if performed as part of a profile. Do not count calculated results such as A/G & BUN/creatinine ratios, osmolality, etc.
AllergensCount each allergen as one test.
CBCCount each measured CBC parameter (WBC/RBC/platelet/hemoglobin/MCV) individually. Do not count calculated results such as automated hematocrit, indices, etc.
Manual or automated WBC differentialsCount manual or automated WBC differentials as one test, regardless of the number of parameters reported.
Immunohematology testsCount each individual immunohematology test (ABO, Rh, antibody screen, antibody identification, crossmatch or other immunohematology test) as one test each.
CulturesCount each culture type as one, regardless of the extent of identification. (e.g., If a sputum specimen is provided for routine culture, gram stain, AFB smear and culture, and a mycology culture, it counts as five tests.
Antimicrobial susceptibility testsCount each test as one, regardless of the number of disks.
Direct parasite smear/concentrationCount each specimen as one test.
Trichrome stains, etc.Count each specimen as one test.
Pathology and CytologyCount each specimen as one test.


Reporting Medicaid Fraud