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The page below is a sample from the LabCE course Laboratory Effectiveness: Clinical Laboratory Utilization. Access the complete course and earn ASCLS P.A.C.E.-approved continuing education credits by subscribing online.

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Obsolete Tests or Tests Not Recognized by CMS

In 2007, Clinical Laboratory News published a survey asking laboratory directors their opinion concerning some potentially obsolete tests. In the accompanying graph you can see that many lab directors felt that the tests listed were obsolete. Today, there is even greater agreement.
There are even more tests that, while not 'obsolete', are just simply overused. Some of the tests that are clearly or of veryf little value include:
  • Zinc protoporphyrin: (has been abandoned as a lead poisoning test)
  • Free T4 index (a calculation based on the now obsolete resin uptake test)
  • Bleeding time
  • Reverse T3
  • IgG allergen testing
  • Propoxyphene testing (this drug was taken off the market)
  • PCP testing (PCP may still be present in some areas but nationally, abuse is not common)
  • Urine bilirubin: false positives are common. Serum bilirubin is a much better test.
There are also many unusual tests that most laboratory professionals have never heard of. These are listed in the bottom image on the right. These tests are not recognized by the Centers for Medicare & Medicaid Services (CMS) and are not covered by most insurers. However these tests still get ordered, sometimes by alternative medicine providers (ie, naturopaths).
*Reference: Levenson D. Which tests should be considered obsolete? Clin Lab News, December 2007:33(12).