• Complete ALL patient demographic information (name, DOB, or SSN).
  • Provide at least the two unique patient identifiers including legal name and birthdate.
  • Include ordering provider.
  • Order test(s) desired by checking box to the left of the test or write in orders in the space provided on the bottom of the page.
  • Provide ALL applicable ICD-10 code(s) (diagnosis) for the test(s) ordered (there is NO limit to the # of diagnoses for laboratory tests) either by checking the boxes that apply or writing them in the field provided when using a paper requisition. When using an electronic interface some restrictions may apply so the use of the most relevant codes is beneficial.
  • Use diagnosis that describes why you ordered a test NOT why you are seeing the patient, e.g., the reason a reticulocyte is ordered is for anemia (established diagnosis, symptoms, or signs) NOT the leukemia for which the patient is being treated.
  • Do NOT use "rule out" as a diagnosis; use signs/symptoms, or use signs &/or symptoms that cause to want to "rule out" a disorder or disease, e.g., a patient exhibits polyuria, sweating, and polyphagia. Diabetes is to be ruled out. These symptoms/signs justify ordering a glucose.
  • Be sure to document the test orders in patient records not just on the requisition form.