Reflex Testing

The WellSpan Laboratory will perform reflex tests automatically when defined criteria have been met or when considered to be a routine standard of practice. The Medical Executive Committee reviews and endorses the reflex tests.

Conditions for Performance of Reflex Tests

A reflex test will be performed when:

 1. A specific test with a reflex option listed in the chart is ordered. These tests can  be ordered with or without the reflex option. When ordered with the reflex option, and when the reflex criteria are met, additional testing will be performed.

     Example: Urinalysis, culture if indicated

 2. A test result or patient demographic meets the established and approved criteria to prompt reflex testing. This is considered a standard of practice.

 Billing

 1. Reflex tests are billed only when performed.

  2. If the established criteria are not met, no further charges will be generated.

  3. When tests are billed to Medicare, a CPT code for those procedures performed will be submitted and Medicare will reimburse each hospital according to the fee schedule.

 Reference Laboratory Tests

Tests performed at approved reference laboratories will have reflex testing performed when testing meets criteria defined by the reference laboratory. This reflexive testing can be found in the reference lab procedure catalog, or the WellSpan lab procedure catalog.