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# Order Forms Guide - Specifying diagnosis codes at the lab test level
## Overview
### What are test-level diagnosis codes for labs?
You can now assign specific diagnosis codes to individual lab tests in a lab order to improve documentation accuracy and ensure precise coding.
### What are the differences between test-level diagnosis codes and order-level diagnosis codes?
The table below highlights the differences between test-level diagnosis codes and order-level diagnosis codes. Both test-level and order-level diagnosis codes are optional, as long as each test has a diagnosis code assigned at either level.
| **Test-level diagnosis codes** | **Order-level diagnosis codes** |
| ----------------------------------------------------------------------------------------------------- | --------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| Test-level diagnosis codes link specific diagnosis codes to individual lab tests. | Order-level diagnosis codes link the specified diagnosis codes to all tests in the lab order, even if those lab tests have test-level diagnosis codes. |
| Test-level diagnosis codes provide greater precision in explaining the medical necessity of the test. | Order-level diagnosis codes conveniently apply a set of codes to all tests in the order, eliminating the need to assign the same diagnosis codes to each test individually. |
| Test-level diagnosis codes take precedence over order-level diagnosis codes. | Order-level diagnosis codes are secondary to test-level diagnosis codes. |
## Workflow Instructions
### Selecting test-level diagnosis codes in lab orders
| **1** | Create a new lab order using one of the methods outlined in [this article](/articles/ordering-lab-tests-enhanced#create) . |
| ----- | ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ |
| 2 | Enter the test(s) you want the patient to complete. |
| 3 | Click **Add Dx** to any test to assign a test-specific diagnosis. |
| 4 | Type the diagnosis code or diagnosis description in the **Add test specific Dx code** field to search for and select the diagnosis you want to assign to the specific lab test. Assign as many test-level diagnosis codes as needed. Test-level diagnosis codes take precedence over order-level diagnosis codes. • If you assign multiple diagnoses for a given test, the sequence of test-level diagnosis codes indicates their level of importance. The first code in the list is considered the primary diagnosis, the second as the secondary diagnosis, and so on. |
| 5 | Proceed with completing the lab order. |
### Selecting order-level diagnosis codes in lab orders
| **1** | Create a new lab order using one of the methods outlined in [this article](/articles/ordering-lab-tests-enhanced#create) . |
| ----- | ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| 2 | Enter the test(s) you want the patient to complete. |
| 3 | Type the diagnosis code or diagnosis description in the **Add Dx codes that apply to all tests…** field to search for and select the diagnosis you want to assign to all tests in the lab order. Assign as many order-level diagnosis codes as needed, as long as the lab order does not exceed 120 unique diagnosis codes. Order-level diagnosis codes are secondary to test-level diagnosis codes (if any were added to specific tests). • If you assign multiple diagnoses to the order, the sequence of order-level diagnosis codes indicates their level of importance. |
| 4 | Proceed with completing the lab order. |
### Assigning diagnosis codes to order sets
Both test-level diagnosis codes and order-level diagnosis can be saved to lab order sets. Follow the instructions in[this help center article](/articles/ordering-lab-tests-enhanced#order_sets)and assign diagnosis codes as needed.
## Frequently Asked Questions
### Do I need to add a test-level diagnosis code to every test in the lab order?
No, adding a test-level diagnosis code to every test in the lab order is not required. Tests without a test-level diagnosis code will automatically be linked to the order-level diagnosis codes.
### Do I need to add order-level diagnosis codes to a lab order if it already has test-level diagnosis codes?
No, order-level diagnosis codes are not required if each test has an associated test-level diagnosis code. However, if any test lacks a test-level diagnosis code, you must either assign a test-level diagnosis code to that test or add an order-level diagnosis code.
### How does the lab interpret test-level diagnosis codes versus order-level diagnosis codes?
Test-level diagnosis codes take precedence over order-level diagnosis codes. See the example below:
* The CBC was not assigned any test-level diagnosis codes, so it will be linked only to the order-level diagnosis code E11.9, which will be treated as the primary diagnosis code for the CBC.
* The BMP was assigned two test-level diagnosis codes and is also linked to the order-level diagnosis code E11.9:
* C22.1 will be treated as the primary diagnosis code since it is the first test-level diagnosis code.
* H40.1190 will be treated as the secondary diagnosis code as it is the second test-level diagnosis code.
* E11.9 will be treated as the tertiary diagnosis code because it is associated at the order-level.
### Can I move a diagnosis code from the test-level to the order-level or vice versa?
Diagnosis codes cannot be relocated. To change their placement, remove the code from the current location and re-add it to the desired one.
### How many diagnosis codes can I add to a single lab order?
You can add up to 120 unique diagnosis codes per lab order.
**Related Articles**
* [Order Forms Guide- Ordering lab tests with the Lab Order Form](/articles/ordering-lab-tests-enhanced)