Instruction for Use (Guide)

LDS ™ is a test ordering and utilization management software that assists healthcare providers in selecting and ordering the most appropriate laboratory tests using evidence and knowledge-based guidelines and industry best practices.

LDS® utilizes our proprietary ranking system and enables healthcare providers and care managers to select the most relevant tests based on procedures, CPT codes, diseases, or ICD10 codes.

The ranking system scores potential tests for any given disease and assigns an easily interpretable numerical/color-coded score based on clinical relevance, medical necessity, and testing indication.

The content can be used as a web based and smart phone application and can be integrated with LIM, EMR and EHR systems.

To download the smartphone app, go to the app store and search for “Laboratory Decision System” and follow the directions.

For integration with LIM, EMR and EHR systems call 949-208-0521.

Test Scoring System Used by Laboratory Decision System (LDS)

Numerical ratings appear on a scale from 0 to 10. This rating, or "score" corresponds to a percentage divided by a factor of 10 for presentation. For example, a score of 6 corresponds to a 60% probability of appropriateness, etc. The score represents the likelihood that a given medical test will be relevant/appropriate for a given indication. It is important to note that the score is based on a combination of (i) the medical evidence (published guidelines, recommendations), (ii) rater’s professional judgment and expertise, and (iii) any quantitative data that may be available (such as sensitivity, specificity, etc.). So, while the resulting ranking may imply a purely quantitative derivation, qualitative factors often will significantly contribute to the calculation.

A test with a score of 10 for a given diagnosis will either directly support or rule out the diagnosis. For example, if the result of such a test is abnormal, it will most likely support the diagnosis of the suspected disease. However, if the result of the same test is normal, it will most likely rule out the diagnosis of the suspected disease. Similarly, a test with a score of 9, 8 or 7 will also support or rule out the suspected diagnosis, but in a less specific manner.

In general, tests with scores from 5-10 are considered to be positively relevant and more than likely will meet medical necessity for the selected disease. Tests with scores below 5 are not likely to meet medical necessity, but still may be used as ancillary, supportive, or optional tests and will typically include an explanatory footnote.

In addition to the numerical score, our rating interface also groups scores by color:

  • Scores from 7 - 10 appear green - Ordering physicians are likely to order such tests with little or no question.
  • Scores from 5 - 6 appear yellow - Ordering physicians are likely to hesitate before ordering such tests, with many of these being considered optional and often will be accompanied with an explanatory footnote.
  • Scores from 0 - 4 appear red Ordering physicians are unlikely to order such tests.

Therefore, users should consider scores both in light of the “fine-grained” numerical score, as well as in terms of the more “coarse-grained” color group to which the score belongs (i.e., green, yellow, and red)

How it Works (Instructions for Use)

Test ordering or test search

Test can be ordered or search by disease and/or ICD10 codes or by procedure/test or CPT codes.

Ordering By Diseases or ICD10

When ordering tests by disease or ICD10, each disease will list tests associated with the disease ranked and scored from 1-10 based on specificity to the disease, clinical relevance and medical necessity, with the 10 score being most associated and clinically relevant.

Since each disease is assigned its own ICD10, every submitted order order automatically will include the correct ICD10 to meet the medical necessity.

Co-morbity (more than one disease)

Many patients might suffer from more than one disease or conditions. In such cases, our software is able to add additional diseases to the primary disease order. Tests for the additional diseases will be added to the primary disease order without doubling or overlapping scored tests for the primary disease. LDS automatically will include the ICD10 codes for the additional disease’s tests with the primary disease’s ICD10 code, so any time an order is sent to the lab, it fwill list ICD10 codes for both diseases to meet its medical necessity.

Ordering By Test

When searching by test, the system will list diseases associated with the test. Each disease will have a score ranking from 1-10 based on specificity, clinical relevance and medical necessity to the listed tests, with the 10 score being most associated and clinically relevant.

Since each disease has its own ICD10, every test order sent automatically will include the correct ICD10 that meats the medical necessity.

Just click on the disease listed and the system will take you to the ICD10 codes. Select the right ICD10 to send the order with that ICD10 code.

Ordering By Testing Indication

Our system follows Medicare and Medical guidelines to minimize ordering of unnecessary tests.The system uses the following Testing Indications:

  • Screening/Initial testing
  • Diagnostic testing
  • Disease Management testing
  • Other Supportive/Alternative testing

Screening/Initial Testing Indication

This testing indication offers physicians a good start with the most likely disease related testing to get more findings to non-specific presented symptoms.

As a result, the selected tests are usually simple, quick, inexpensive, and provide a good lead for further diagnostic testing.

The system will default to “initial/screening” testing indication, displaying only those tests listed under this indication.

Diagnostic Testing Indication

In general, diagnostic testing can be viewed as the logical continuation of the screening indication with the goal of identifying the suspected disease. Selected tests are usually diagnostic, esoteric, sophisticated, expensive, and often diagnostically confirmatory.

To see listed tests under the diagnostic indication, click on the diagnostic indication to expand. The system will show the list of tests under this indication.

Disease Management Testing Indication

The disease management testing indication also known as “follow up testing” applies to tests used to monitor the treatment and management of disease.

To see listed tests under the disease management indication, click on the disease management indication to expand. The system will show the list of tests under this indication.

Other Supportive/Alternative testing

Testing under this testing indication is alternative or supportive to primary or diagnostic testing and is usually used when no diagnosis can be made with primary or diagnostic testing. If the correct diagnostic ICD10 is used, these tests meet the medical necessity and most likely will be reimbursable.