Laboratory tests listed below are considered routine and are included as part of the composite rate of reimbursement. All other medically necessary lab tests are considered nonroutine and must be billed directly by the actual provider of service.

1. (a) Hemodialysis

   1. 1. Per treatment - All hematocrit and clotting time tests furnished incidentally to dialysis treatments.
   2. 2. Weekly - Prothrombin time for patients on anticoagulant therapy; serum creatinine, BUN.

   3. 3. Monthly

      Serum Calcium	Serum Biocarbonate
      Serum Potassium	Serum Phosphorous
      Serum Chloride	Total Protein
      Alkaline Phosphatase	LDH
      SGOT

      Monthly.

      BUN	Total Protein
      Creatinine	Albumin
      Sodium	Alkaline Phosphatose
      Potassium	LDH
      C02	SGOT
      Calcium	HCT
      Magnesium	Hgb
      Phosphate	Dialysis Protein

2. (c) All laboratory testing sites providing services to Medicaid recipients, either directly by provider, or through contract, must be Clinical Laboratory Improvement Amendments (CLIA) certified to provide the level of complexity testing required. Providers are responsible to assure Medicaid that all CLIA regulations are strictly adhered to, both now and as regulations change in the future. Providers are responsible for providing Medicaid waiver certification numbers as applicable.
3. (d) Laboratories which do not meet CLIA certification standards are not eligible for reimbursement for laboratory services from the Alabama Medicaid Program.

Statutory Authority: State Plan; Title XIX, Social Security Act; 42 C.F.R. § 405.2163.

History: Rule effective October 1, 1982. Amended: Effective January 14, 1987. Amended: Effective May 11, 1993.