Add-On Requests/Test Additions
Additional testing may be requested if the specimen is suitable for further testing. Clients should contact NorDx Client Support to request additional testing and to have an authorization form completed. When the specimen is retrieved, the client will be notified if the specimen cannot be analyzed.
Client - Our monthly invoices are itemized and indicate the date of service, patient name, requisition number, log number, test name, and test charge. Payment is due within 30 days of billing date.
Third Party Billing - If you elect to have NorDx third-party bill for services, please include the following necessary billing information:
- Patient and guarantor name, complete address (including zip code)
- Guarantor's relationship to patient
- Home and work telephone numbers
- Patient sex
- Patient date of birth
- Complete name of referring physician with UPIN number
- Certificate number, policy number, Medicare number
- Group number (if applicable)
- Name of policy holder
- Address of insurance company
- Diagnosis (ICD9 code) or reason test was ordered, and any other information from the patient
To ensure accurate and timely claims adjudication through the insurance carrier, NorDx needs the above information within 10 business days from the date of service or the account may be client billed.
Specimen Identification Requirements
Policy Statement - In order to assure positive identification and optimum integrity of patient specimens, NorDx requires that the following labeling guidelines be followed. Specimens that do not meet these guidelines will be rejected and will not be accepted by the laboratory for testing.
Exception - If a specimen does not conform to guidelines and is a unique, irretrievable, or difficult to obtain, such as CSF, surgical specimen, aspirated body fluid, or biopsy, NorDx Client Support will contact the client to obtain written acknowledgement of the inadequate specimen labeling prior to testing the specimen. The final written report will include the acknowledgement of the specimen condition.
Minimum Label Requirements:
- The minimum label requirements for all specimens to be tested, (except for Blood Bank - see Blood Bank requirements) are full first and last name and a second identifier, e.g., date of birth or medical record number (MRN).
- The source of a specimen is required on the collection container or requisition of all specimens except blood, urine and stool.
- In the case of multiple specimens on the same patient, the label must include the source of the specimen.
- If the date/time of the specimen is relevant to the interpretation of the test result it must be included on the specimen label.
Examples: GTT, cortisol, multiple stool specimens, peak/trough drug levels.
- The source of a specimen is required on the secondary, transport, transfer, or aliquot container of all specimens except serum.
Recommended Label Requirements (see Blood Bank Label Requirements below)
In addition to the minimum requirements, it is recommended that a specimen label include:
- Date and time of collection
- Initials of the person performing phlebotomy
- Physician's name on Anatomic Pathology specimens
Blood Bank Label Requirements
Blood Bank specimen labels require that the following information be accurate and identical on the specimen, requisition and blood bank history:
- Last name, first name (use legal name - no nick names/shortened names)
- DOB or medical record number
- Phlebotomist's initials
- Specimen date
The specimen label MUST be completed prior to leaving the side of the patient. After leaving the patient, NO CHANGES MAY BE MADE to the specimen label. If the information is not accurate or incomplete, a new specimen MUST be collected. Contact Blood Bank directly (207-871-2121) with any questions. Procedure to Obtain Or Correct Specimen Information
Clarification is required for the following specimens:
- Questionable source
- Last name, first initial
- Last name, nickname
- Minor spelling errors
- Any discrepancy in specimen identification between the requisition and specimen label
A specimen is stabilized and held until required information is obtained or a specimen is tested and results not released until information is obtained (see Blood Bank Label Requirements).
Non MIS patient:
- The CSA process is used to obtain or correct information on specimens eligible for testing. Except for Blood Bank specimens (see Blood Bank Label Requirements), NorDx will accept a signed letter of responsibility from an authorized ordering provider or the person who obtained the specimen to proceed with testing.
- A NorDx Investigation/Action Form is completed for Anatomic Pathology specimens.
MIS patients: Specimen Management at MMC campus or BMC staff are responsible for obtaining required information from the originating location of specimens eligible for testing.
- If a specimen label includes a nickname or a misspelling such as two letters transposed or an incorrect letter, Specimen Management may verify the identity using patient specific demographic information in SCC (except Blood Bank specimens). For testing purposes, the SCC label is used for identification of the specimen.
- A CSA is ordered if a misspelling changes the patient PID and/or created a new stay.
- A CSA is ordered if a specimen is labeled with an initial in place of a full first name and the requisition lists a first name.
- A CSA is ordered if the source of a specimen is not listed on the label or requisition as required (see Minimum Label Requirements).
Specimen Rejection Policy
- An unlabeled specimen or a specimen with the incorrect patient name is rejected and is not submitted for testing. If a specimen does not conform to the minimum label requirements and is unique, irretrievable, or difficult to obtain, such as CSF, surgical specimen, aspirated body fluid, or biopsy, consult the person in charge of the testing section or pathologist for instructions in proceeding.
- A rejected specimen is stabilized and held for 5 days. Blood Bank specimens may not leave the Blood Bank once received.
- Non MIS patient: Order and complete appropriate fields of a CSA to notify Client Support of the rejection.
- MIS patients: Notify the originating location of the specimen of the rejection. Document the rejection on a Specimen Rejection Form in Specimen Management, MMC campus and Brighton Campus.
Cancellation of Tests
Cancellations received prior to test setup will be honored at no charge. Requests received following test setup cannot be honored. A report will be issued automatically and charged appropriately.
Research Study Participation Inquiries
NorDx has available specific resources and capabilities for research studies. Contact NorDx Client Support for further information.
Confidentiality of Results
NorDx endeavors to maintain the confidentiality of all patient information. To ensure the appropriate release of patient results in response to a telephone inquiry, one of the following may be required:
- Requisition number
- NorDx accession ID number for specimen
- Client account mnemonic from NorDx
We appreciate your assistance in helping NorDx preserve patient confidentiality. The provision of appropriate identifiers will greatly assist in a prompt and accurate response to result inquiries.
NorDx through MMLNE has available a chain-of-custody. Appropriate forms, boxes, and instructions can be obtained on request. Medicolegal specimens must be accompanied by the forms supplied by NorDx.
Specimens from patients receiving radioactive tracers or material should be labeled as such. Specimens are not routinely tested at NorDx for background radioactivity. This radioactivity may invalidate the results of radioimmunoassays.
Rejected Specimens - Parasitology
- Multiple same-day specimens (one specimen will be processed)
- Pinworm exam submitted on frosted tape
- "Qualified" Specimens (qualified specimens are not credited):
- Unpreserved stool for ova and parasite exam
- The polyvinyl alcohol (PVA) vial was overfilled (beyond the top of the label) with specimen
- The specimen in PVA was not adequately emulsified
- A stool specimen was submitted for pinworm exam
Occasionally, test results do not "fit the clinical picture" of the patient. Under these circumstances, the test will be repeated at no charge. Routinely completed specimens are retained for at least one week which allows additional test requests or repeat testing when necessary. Please contact NorDx Client Support to request a repeat test or an additional request.
Mailing cartons, specimen vials, special specimen collection containers and kits, sterile vials, stool containers, and request forms are supplied without charge for specimens sent to NorDx for testing.
Test Turnaround Time
Our test catalog lists the days on which the test is set up and the analytical time as a guide to expected turnaround times. Repeated tests may take additional time.
Some specimens cannot be analyzed because of improper collection or degradation in transit. Other specimens may have prolonged turnaround times because of lack of necessary ancillary specimens or patient information.
You will be notified of rejected or problem specimens upon receipt. To avoid specimen rejection, please use the following checklist.
Are the following conditions correct? Please check the test catalog.
- Full 24 hours for timed urine collection
- Lack of hemolysis or lipemia
- Patient information requested
- Patient/specimen properly identified
- pH of urine
- Specimen container (sterile, metal-free, separation gel, etc.)
- Specimen type (serum, whole blood, plasma, etc.)
- Specimen source (tissue or fluid type)
- Specimen volume
- Temperature (ambient, refrigerated, frozen)
- Transport medium including fixatives
New procedures are developed throughout the year; therefore, our electronic test catalog will have the most up-to-date information.
Unsatisfactory Analytic Results
If NorDx is unable to obtain a satisfactory analytic result, there is no charge.