Lab Requisition Errors: Costs and Prevention

A missing diagnosis, unclear test name, or patient-information mismatch can stop an order that should have moved straight to testing. Staff then have to find the problem, contact the ordering practice, verify the response, and update the record.

The cost is more than a delayed form. Some errors affect testing; others surface only when billing reviews the claim. Labs can reduce both types of rework by deciding which orders need a hold, who can correct them, and which errors keep recurring.

Which requisition errors need attention first?

Not every incomplete requisition creates the same risk. The lab’s response should depend on what the missing information affects.

A specimen may be suitable for testing even when the related claim lacks supporting information. Missing clinical details, for example, can contribute to medical necessity denials. Requisition review should therefore consider testing and billing separately, using the lab’s policies and the requirements for the specific test and payer.

CLIA guidance on test requests addresses information needed for accurate testing and reporting. CMS’s lab order requirements also describe the documentation the claim-submitting entity must retain.

Who should correct the order?

A correction is straightforward when staff can check reliable source documentation and fix a transcription error. Missing clinical information is different. Lab staff should not select a diagnosis or change the ordered test simply to make an order pass a coverage check.

A useful correction process is:

1. Identify the defect and whether it affects testing, reporting, or billing.
2. Check the source record for information already supplied but entered incorrectly.
3. Contact the ordering practice when the test, diagnosis, clinical details, or provider intent needs clarification.
4. Document the response, verify the change, and release the order or claim when the issue is resolved.

This gives accessioning and billing teams a clear route for corrections without sending every problem through the same inbox. It also preserves a record of where the corrected information came from.

Find the errors that create the most rework

Review one month of requisitions that required manual correction and record:

• The error type and referring practice
• Who resolved it
• How many contacts it took
• Whether testing or billing was delayed

Then calculate the requisition defect rate:

Requisitions requiring correction ÷ total requisitions received × 100

For example, if 80 of 1,000 requisitions need correction, the defect rate is 8%. The more useful finding may be that most of those 80 orders came from one practice or involved the same missing field.

Connecting those defects to later CO-16 denials can help the lab find missing or invalid information before another claim is submitted. Start with the three defects that consume the most staff time, then address where each one begins.

Prevent errors before they reach the lab

Required fields help only when they match the test being ordered. A form should request the specimen details, clinical information, and other inputs that matter for that service. It should flag missing or conflicting information while the ordering practice can still correct it.

The response should match the risk. A patient-identity conflict may require a hold. A possible coverage issue may need review rather than blocking every order automatically.

Docus Digital Requisitions provide configurable forms and checks for missing or inconsistent information during order creation. The goal is to reduce the corrections that lab staff would otherwise discover after receiving the requisition.

Start with one month of orders: find the most common defects, identify where they begin, and update that part of the ordering process. That makes requisition quality a measurable workflow improvement instead of a repeated manual task.