Reflex tests fall into two categories: standard industry practice (example: sensitivities and confirmations) and institutional practice based on standard staff practice.
There is currently no CMS reimbursement policy for (or against) reflex testing. Tests that are reflexed should be reasonable and medically necessary. The medical community should approve reflex protocols. The physician must have the option of selecting a reflex protocol or a single test.
Reviewed and Approved 11/2016, MGH Medical Policy Committee.
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