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Abstract
Reflex testing is a constant problem for clinical laboratory because the government has not provided much in the way of guidance on the subject except as provided in the compliance guidance for laboratories. It is a test that is performed, or not performed, based on the results of another test. Reflex tests are comparable to treatment algorithms or protocols used in physician offices and hospitals. The government's concern is that they can be abused, used by the laboratory to increase volume, or cause unnecessary testing to occur. There are two kinds of reflex tests: 1. those that are common practice including tests where there is regulation that requires the second tests like HIV confirmations, and 2. custom reflex tests where a physician requests one or the laboratory creates one for its own reasons or purposes. Relex testing is very common in the clinical laboratory industry because of its benefits to patient care and efficiency and cost savings it can provide.