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Form Instructions 8801 for Pittsburgh Pennsylvania: What You Should Know

A completed test request form is required to perform testing to make a determination. Affix a patient information label to the test request form or fully complete the information. Submit: 1.¬†Completed¬†test request form (see enclosed form). 2.¬†Patient information form and test information form (see enclosed forms) 3.¬†For a medical test,¬† 4.¬†Sample forms for sample instructions and lab sheets,¬† 5.¬†Test form, 6.¬†Laboratory forms and test sheets or laboratory instructions 7.¬†Lab and patient's report (see enclosed forms) The following are the criteria for eligibility for testing: A. Physical Examination 1.¬†A physical examination must include: (2)¬†A skin temperature of 40.6 or higher (3)¬†A bowel movement of 6.9 g or more (5)¬†(3)¬†Breath sounds and heart sounds (1)¬†A complete examination including evaluation of an individuals physical and mental general Physical and Mental Function B. Laboratory Tests 1.¬†All¬†lab tests require the following: (2)¬†1.¬†Any¬†lab tests are conducted at the facility which the report was prepared and performed by any¬†laboratory having in effect a policy that prohibits receipt by an individual of the results, or data obtained, the test is performed. 2.¬†A patient must receive a copy of the lab test and, in the case of some tests, a copy of the¬†clinical test report in order for the reporting agent to make a determination. 3.¬†For a test or specimen listed under Subsections (B)(v)-(vi): a.¬†Results and data must be available within 24 hours of the laboratory test to which the request is directed by the Reporting Agent (3)¬†The following test or specimen is not eligible for release: 4.¬†All tests are performed by: a. ¬†‚ÄĒ¬†All laboratory records must be stored in accordance with State law and the¬†rules, rules adopted by the state laboratory, and must be available for inspection and copying by the Reporting Agent or by an¬†individual upon request, Note: Each laboratory's policies and procedures must be publicly available for inspection, so the public can know whether the requested test result and clinical test report meet certain criteria¬† a.

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