Effective today, six panels of clinical chemistry testing will be available for ordering in Epic.  Three of these panels are Centers for Medicare and Medicaid Services (CMS)-approved panels.  Similar to existing panels such as Basic Metabolic Panel (Epic #LAB15) and Complete Blood Count (Epic #LAB294), these new panels are orderable as a single unit and may also be cancelled as a single order.  This differs from the previous situation where these panels were constructed in Epic order sets as groups of individual tests.

In terms of patient charges, the CMS panels (CMP, Renal Panel, Hepatic Function Panel) will bill with the corresponding CPT code for the group of tests.  To be consistent between panels, Basic Metabolic Panel (Epic #LAB15), Lipid Panel (Epic #LAB18), Electrolyte Panel (Epic #LAB941) will also be billed with the corresponding group CPT code.  If individual tests within these panels are cancelled (e.g., insufficient specimen available), the remaining tests will be billed individually.  The Chem 6 Panel, Chem 7 Panel, and Liver Panel will bill for the individual tests.

Duplicate rules will be in place to cancel testing if panels are ordered that overlap with other testing order for the same phlebotomy.  Similar duplicate checking already exists for overlaps with other panels such as Basic Metabolic Panel.  Order sets and preference lists within Epic have been updated to the new order codes.

Details of the new panels are included in the two tables below.

Table 1: Panel Names and Order Codes

Panel Name	Epic #	CMS Panel?
Comprehensive Metabolic Panel (CMP)	LAB17	Yes
Chem 6 Panel	LAB7346	No
Chem 7 Panel	LAB7347	No
Renal Panel	LAB5765	Yes
Hepatic Function Panel	LAB20	Yes
Liver Panel	LAB8458	No

Table 2: Testing Contained in the New Chemistry Panels

CMP	CHEM6	CHEM7	Renal Panel	Hepatic Function Panel	Liver Panel
Na	Na	Na	Na
K	K	K	K
Cl	Cl	Cl	Cl
CO2	CO2	CO2	CO2
BUN	BUN	BUN	BUN
Creatinine	Creatinine	Creatinine	Creatinine
Glucose		Glucose	Glucose
Calcium			Calcium
Total protein				Total protein	Total protein
Albumin			Albumin	Albumin	Albumin
AST				AST	AST
ALP				ALP	ALP
Bilirubin, total				Bilirubin, total	Bilirubin, total
ALT				ALT	ALT
			PO4
				Bilirubin, direct
					GGT

Questions should be directed to Matthew Krasowski, MD, PhD, medical director of the Clinical Chemistry Laboratory (384-9380, matthew-krasowski@uiowa.edu).