If you have not previously filled out a patient registration form or if any information has changed in the past six months, you will need to complete all required information below so that we can successfully bill the patient’s Insurance. Otherwise, the patient will be billed.
Download a flyer that shows the importance and facts around critical values.
This requisition includes supplies commonly ordered by physician offices.
Complete and submit with all requests for the Quad Test Profile or Alpha Fetoprotein, Serum, Maternal.
It is the policy of Michigan Medicine Laboratories (MLabs) to perform reflexive testing when appropriate; this Reflexive Testing policy is approved by the UMHS Executive Committee on Clinical Affairs. Reflexive testing includes semi-quantitative titers in the case of some positive screening tests, appropriate confirmatory procedures in the case of some screening identification assays, and appropriate pathologists' interpretation of some study results. If a test is reflexed for further testing, additional CPT codes and charges for the added tests will be billed to the client or third party payor. Potential additional charges are noted in the MLabs Test Catalog and on the test requisition.
This form can be used to provide or revise ICD-9 or ICD-10 code(s) submitted for insurance carrier billing.
These guidelines cover all general specimen and transport details, including packing instructions, shipping, supplies, specimen container information, labeling, specimen handling, etc.
This document covers tests that do not require prior approval to be performed on a STAT basis. MLabs will report STAT call-back results by telephone, immediately upon verification of result accuracy. Requests for STAT call-backs must be clearly noted on the test requisition or by calling MLabs Client Services. Results will be called to the referring facility unless otherwise specified.
These instructions cover stool collection for the following: ova and parasite, stool culture (Cary-Blair), Giardia Antigen, Gastrointestinal pathogen panel, Clostridium difficile and fecal occult blood test.
The subspecialty services brochure covers information about our renal, neuromuscular and dermatopathology specialties.
This requisition should accompany any surgical or cytological specimens, including Muscle, Nerve, or Renal biopsy specimens. Be sure to fully complete all portions of the relevant section.
This document covers the protocols and specimen handling for vitreous specimens. Please Michigan Medicine Laboratories (MLabs) Client Services prior to sending a vitreous fluid specimen. Vitreous shipping materials are available from MLabs and will be required in advance of the procedure. MLabs Client Services can be reached at 800.862.7284 or 734.936.2598 (local). The recommended testing of Vitreous or Aqueous Fluid for evaluation of primary intraocular lymphomas and vitreoretinal lymphoma are the B Cell Clonality (IGH & IGK Gene Rearrangement) and MYD88 (L265P) Mutation assays available from MLabs Molecular Diagnostics Laboratory.
This form is a w-9, a request for taxpayer, identification number and certification used for MLabs.