What is the best method for screening for prozone phenomenon in endomysial antibody testing?

The standard protocol to screen for prozone phenomenon at IMMCO is to test the specimen at dilutions of 1:2.5 and 1:10. This will identify the great majority of high titer cases that might prompt a negative result when samples are only screened at 1:2.5. Certain very high titer reactions may produce a prozone effect at 1:10 with a suspicious, sometimes granular, weak pattern. If this is seen, our laboratory re-tests the specimen at 1:20. This is extremely rare and only in cases with titer >1:5280.

Why was my specimen sent to Immco Diagnostics for testing?

Immco Diagnostics is recognized as the leader in autoimmune testing and has established an excellent reputation with medical specialists who rely on our expertise, high quality and cutting edge diagnostic services. Our services include serology, genetics, pathology in many fields. Some of these include dermatology, dermatopathology, endocrinology, gastroenterology, hepatology, ocular and oral pathology, otolaryngology, neurology and rheumatology.

How do I request testing to be performed at Immco Diagnostics?

Immco Diagnostics will supply your office with specimen collection kits, free of charge. If you draw in your office, place the patient’s serum in the kit and return to Immco by FedEx, using the preprinted labels. If you do not draw in your office, the specimen may be drawn at other draw stations, however, please confirm that the phlebotomy site is able to submit specimens to Immco. Certain draw sites will only submit specimens for testing in network. If the draw site can submit specimens to Immco, please give the patient a specimen collection kit with a script for the draw. The draw station will return the kit to Immco at no charge. Immco is establishing draw locations regionally.

How do I obtain supplies to submit a test?

Immco Diagnostics supplies specimen collection kits free of charge. You can call (716) 691-0091 or 800-537-TEST, ext. 310/321, to obtain the kits. If you draw in your office, the specimen can be placed in the kit and returned to Immco by FedEx, using the preprinted labels. The specimen can also be drawn at any draw station, give the patient a specimen collection kit along with a script for the draw. The draw station will return the kit to us. Also we can provide you with a list of draw stations in the Upstate New York area and arrange for pickup by a courier.

How long are the specimens stable for?

Specimens for most of the tests are stable at ambient temperature during shipment. If a sample is stored prior to shipment, it is stable refrigerated (2-8 degrees centigrade) for up to 5 days, and frozen (-20 degrees centigrade) up to a year. However, the viability differs with different specimens; for example, stability for serum may be different than for a biopsy or mucous specimen. Please check the Test Request Form under “Specimen Requirement” for information. If you have any questions, please call Immco Diagnostics at 800-537-TEST, ext. 321 and our staff will be happy to assist you.

Why was my specimen unacceptable for testing?

A specimen may be unacceptable due to a number of reasons, for example, if the vacutainer tube it is collected in is not specific for the test requested as the test may require serum or whole blood, or plasma for testing. If the blood is icteric or hemolysed, the specimen is unacceptable as it interferes with the fluorescence. Also, biopsy site for various immunological and histological tests varies depending whether a lesional, perilesional or normal biopsy specimen is required. The specimen then has to be placed in the right color tube provided in the kit, as the solutions in the tubes are different depending upon whether it is an immunological or histological test. For specialized mucous tests, specimen collection and viability differ from the standard specimen collection. Please refer to the individual Test Request Forms under “Specimen Requirements”. For additional information, please consult the Collection and Handling Section in the TEST REFERENCE MANUAL. If you have any questions, please call Immco Diagnostics at 800-537-TEST, ext. 300, and our staff will be happy to assist you.

What insurance companies does Immco work with?

Immco works with state Medicare plans and many other providers. However, the list of plans with which Immco participates frequently changes. Immco does not accept Medicaid. Please call Immco billing department at 800-537-8378, ext. 314/315 between 8:00am. to 4:30pm.

What is Immco Diagnostics CLIA Number?

The CLIA Number is 33D0170905. This number appears on Immco New York State Laboratory License, issued by New York State Department of Health. Laboratories in New York are not provided a separate CLIA license. If you need further assistance or a copy of the New York Laboratory License, please call the billing department at 800-537-8378, ext. 314/315 between the hours of 8:00am to 4:30pm.

What is Immco Diagnostics Federal ID Number?

The Federal ID Number is 16-1012347. If you need further assistance, please call the billing department at 800-537-8378, ext. 314/315 between the hours of 8:00am to 4:30pm.

What is Immco Diagnostics NPI Number?

The NPI Number is 1801860697. If you need further assistance, please call the billing department at 800-537-8378, ext. 314/315 between the hours of 8:00am to 4:30pm.

Does Immco Diagnostics participate with Medicare and what are the billing requirements?

Immco Diagnostics is a Medicare Provider. If the patient has Medicare coverage, please send complete information. Immco Diagnostics will bill Medicare and accept 80% assignment. Complete information must be entered on the Test Requisition Form at the time the specimen is submitted. Please note: Due to HIPAA Transaction Code Standard effective 16/10/2003, a valid diagnosis code is mandatory for billing Medicare. Medicare billing information is not complete and will not be accepted without a valid diagnosis code. Billing Information Requirements (to be entered on Immco Diagnostics Test Requisition Form): Patient Full Name (as it appears on the card) Patient Address, including City, State, Zip Patient Phone Number with Area Code Patient Sex Patient Date of Birth Medicare HIC# (9 numeric’s + 1 alpha suffix) Diagnosis (ICD-9-CM code) applicable to the patient’s condition at time of service. Referring Physician’s Name (First, MI, Last) Referring Physician UPIN # (5 digits +alpha prefix). *This information must be included on Immco Diagnostics Test Requisition Forms at time of service*

My Insurance does not participate with Immco, is there a way to have this test covered?

Yes, most insurers will cover tests performed at Immco Diagnostics with pre-approval, by granting an “out of plan provider status”. If you would like additional information, please call Immco Billing Department at 800-537-8378, ext. 314/315 between the hours of 8:00am. to 4:30pm.

Will Immco Diagnostics perform tests on patients without insurance or with insurance that does not participate?

Yes, Immco Diagnostics is recognized as the leader in autoimmune testing, with our expertise and rapid turnaround time, many physicians recommend us to their patients even though their insurance company is not a provider. Immco Diagnostics will bill the patient directly and the patient can pass this bill on to the insurer to be reimbursed. In order to do this we need the patient’s signature and authorization at the time of service. Any questions, please call the Immco billing department at 800-537-8378, ext. 300.

Why was my specimen unacceptable for testing?

A specimen may be unacceptable due to a number of reasons, for example, if the vacutainer tube it is collected in is not specific for the test requested as the test may require serum or whole blood, or plasma for testing. If the blood is icteric or hemolysed, the specimen is unacceptable as it interferes with the fluorescence. Also, biopsy site for various immunological and histological tests varies depending whether a lesional, perilesional or normal biopsy specimen is required. The specimen then has to be placed in the right color tube provided in the kit, as the solutions in the tubes are different depending upon whether it is an immunological or histological test. For specialized mucous tests, specimen collection and viability differ from the standard specimen collection. Please refer to the individual Test Request Forms under “Specimen Requirements”. For additional information, please consult the Collection and Handling Section in the TEST REFERENCE MANUAL. If you have any questions, please call Immco Diagnostics at 800-537-TEST, ext. 321, and our staff will be happy to assist you.

Can Immco guarantee full reimbursement?

No, Immco cannot guarantee full reimbursement, however, our billing department will courtesy bill the kit and returned to Immco by FedEx, using the preprinted labels. The specimen can also be drawn at any draw station, give the patient a specimen collection kit along with a script for the draw. The draw station will return the kit to us. Also we can provide you with a list of draw stations in the Upstate New York area and arrange for pickup by a courier.

What is an out-of-network laboratory?

Certain insurance providers reimburse testing for those laboratories with which they have established contracts. A laboratory that is not under contract with an insurance provider for a particular testing is an “out-of-network laboratory”. Patients may need to obtain a pre-authorization for reimbursement for fees charged by an “out-of-network laboratory”.

What is pre-authorization?

Certain insurance providers require a patient to contact them for approval to see a specialist or access services from health care organizations that are not under contract with them. Generally, pre-authorization or referral from a primary care physician to see a specialist will also cover reimbursement of fees for testing ordered by the specialist. However, this is not always the case. If you have questions or concerns about whether pre-authorization for a particular test is required by your insurance plan, we encourage you to contact your provider.

Does insurance cover the tests?

It depends. Generally, insurance providers will cover the tests in full or in part with the amount reimbursed determined by your particular insurance plan. In certain cases, however, an insurance provider may require pre-authorization for certain tests or refuse to reimburse for testing sent to an out-of-network laboratory.

Why is it important to provide the Diagnosis codes (ICD-9) on the requisition form when ordering a test?

Every third party bill must have a valid diagnosis code. Please be sure to put the ICD-9 Code(s) applicable to the patient’s condition for the specified date of service on the requisition in the box marked “Diagnostic Codes ICD-9)”. Medicare diagnosis codes must be coded to the highest level of specificity. Please refer to the International Classification of Diseases (ICD-9) manual, as well as Medical Regulations and Manuals issued or authorized by the Center for Medicare and Medicaid Services (CMS) for diagnosis coding rules and regulations.

How can I get a list of the CPT Codes for the tests?

CPT codes are listed in the Directory and are provided only as a guidance to assist you in billing. CPT codes listed reflect our interpretation of CPT coding requirements and are subject to change at any time. It is the client’s responsibility to verify the accuracy of the codes. If you have any questions, please refer to the Current Procedural Terminology (CPT) manual by the American Medical Association. To verify reimbursement or if you have any questions regarding usage of a CPT code, please contact your local Medicare carrier.

What is the FDA status for specific tests?

Refer to the Reference Lab Regulatory Status file

Does Immco Diagnostics Laboratory participate with any insurers?

Yes, at present Immco Diagnostics is a provider or has been recognized by many insurers throughout the US. For a list of providers, please call Immco Billing Department at 800-537-8378, ext. 314/315 between the hours of 8:00am to 4:30pm.

What is Third Party Billing?

Immco Diagnostics will bill the patient’s insurance directly for tests performed by Immco Diagnostics if complete billing information is provided on the Test Requisition Form at the time the specimen is submitted. Immco Diagnostics will not bill third party payers for referral testing submitted to Immco diagnostics for performance by a send out laboratory. Billing information requirements (to be entered on Immco Diagnostics Test Requisition form): Patient Name Patient Date of Birth Patient Sex Patient Address, including City, State, Zip Patient Phone Number with Area Code Patient Relationship to Subscriber Insurance Carrier Name Insurance Carrier Address, including City, State, Zip Subscriber Name and Date of Birth CONTINUATION: Policy Number or Member ID Group Number Medicare Number, if applicable Requesting Physician Name Requesting Physician UPIN, Provider # or License # Diagnosis (ICD-9-CM Code) applicable to the patient’s condition at time of service. Patients are responsible for the yearly deductibles, co-payments and any balance not covered by the insurance company. If insurance payment is not received within 60 days, the patient is billed directly.

What is patient billing and patient responsibility?

Immco Diagnostics will bill hospital, reference laboratories, clinics or medical groups. Alternatively, Immco Diagnostics will bill patient’s insurance directly, provided all the necessary billing information is supplied at the time services are rendered. Immco Diagnostics can bill the patient’s insurance directly if complete billing information is provided on the Test Requisition Form at the time the specimen is submitted. Immco Diagnostics does not have capitation contract agreements with any HMO’s. Due to Knox-Keene regulations, if a third party payer is initially billed and denied as an HMO member, these charges will be billed back to the patients. Immco Diagnostics will bill Medicare for tests performed at Immco Diagnostics. If a claim is denied as “not eligible for the specified date(s) of service’, the charges will be billed to the patient. Changes to Billing instructions must be supplied within 30 days from the date of invoice. Immco Diagnostics will not process billing instruction change requests received after the 30-day period. The charges will remain the patient’s responsibility. If local or state requirements preclude providing the patient’s name to ensure confidentiality, Immco Diagnostics will be unable to bill patients’ insurance directly; the charges will be billed to the client. Immco Diagnostics Patient Statements are issued immediately following response from insurance. The patient is solely responsible for the charges. Patient’s bills are due upon receipt. Immco Diagnostics does not write off third party insurance balances. If a Doctor mistakenly sends a specimen to Immco Diagnostics and the claim is either unpaid or partially paid as “not contracted providers”, the balance will be billed to the patient. All billing discrepancies should be reported to the Billing Department immediately. Our Billing Department is available from 8:00am. to 4:30pm. by calling 800-537-8378, ext. 314/315 for Billing and Collections.

Does Immco Diagnostics accept “Professional Courtesy” testing?

“Professional Courtesy” testing is strictly prohibited as stated in the Anti-Kick Back Statute U.S.C. 1320a-7b; therefore Immco Diagnostics cannot honor request for this service.

How does Immco Diagnostics bill for Hospital referrals?

Under Medicare rules, Immco Diagnostics can only bill Medicare for a hospital-referred test when the specimen was not collected as part of an inpatient or outpatient encounter, i.e., the specimen was not drawn in a hospital facility or by hospital personnel. All other testing for hospital patients must be billed directly to the hospital.