How to Create and Submit a Lab Order

This guide walks you through the complete process of creating and submitting a lab order in SigmaMD — covering both electronic and fax-based diagnostic providers.

Step 1: Create a Draft Lab Order

From the patient chart, click the Order labs button.

The Order labs button is unavailable, with the tooltip Order labs unavailable, when:

• The patient is deceased
• The patient's profile is incomplete: first and last name, date of birth, sex at birth, a phone number (the patient's or a caregiver's) and a full address with street, city, state and ZIP code
• The patient is a care recipient with no primary guarantor

You also need a diagnostic provider set up for the practice and a clinician who can order from it.

Next, configure the order:

• Diagnostic provider – Choose from available laboratory providers. A fax provider needs an active fax number for the practice location before you can continue.
• Ordering provider – Filled in with your name when you can order from the selected provider; otherwise, choose the ordering clinician
• Billing type – Starts with the provider's default billing:
  • Pay in clinic – Your clinic collects payment from the patient; the lab bills the clinic
  • Use insurance – The lab bills the patient’s insurance directly
  • Pay at service center – The patient pays at the Patient Service Center (PSC). These orders are always PSC draws.

Click Next to continue. Your draft is automatically saved.

You can exit the workflow at any point — the draft will be saved and accessible from the Labs tab in the patient chart.

To delete a draft, click the Delete order icon on the draft order.

Step 2: Add Tests

You can build your lab order by adding tests individually or in groups using preconfigured panels.

• Add Panels – Click the Panels tab to view a list of preset test bundles. Click Add to order to include a panel. To learn how to create panels, refer to this article: Creating Lab Test Panels.
• Add Individual Tests – Click the Tests tab, search by test code or name, and click Add to order to include specific tests.

If a test you need doesn’t appear in the search, see Uploading Your Own Test Compendium for a Fax Diagnostic Provider for a fax-interfaced provider, or Adding Missing Tests for an Electronically Interfaced Diagnostic Provider for an electronic one.

Note: Duplicate tests are not allowed. You cannot manually add a test that is already included in a selected panel.

Favorite Panels or Tests – Click the star icon next to any panel or test to favorite it for quick access. Click the star again to unfavorite.

Remove Tests – To delete a test from the order — whether added individually or as part of a panel — click the Remove test button next to it.

Step 3: Complete Required Fields

Before sending the order, ensure the required fields are complete:

• Pay in clinic orders – All tests must have a price
• Use insurance orders – All tests must have a diagnosis
• All orders – Required AOE questions must be answered

Add Pricing

If a test is missing a price:

• Click Edit test
• Enter a Base price
  • Enter $0 if the patient will not be charged for the test.
  • If the test has no charge item yet, one is created with this price when the order is sent. Otherwise, the price you enter applies to this order only.
• The Retail price will auto-calculate based on markup and tax
• Click Save

Add Diagnoses

You can add diagnoses in two ways:

• Directly on the test – Use the Diagnosis field when editing the test
• Apply to all tests – Click Add diagnoses on the draft order screen

Additional Fields

• AOE questions – Some tests include questions for lab processing. A test with unanswered required questions shows a required count; click Review AOE Questions to answer them.
• STAT – Check it to mark the order as urgent.
• In-office draw – The draw type starts with the provider's default. Check In-office draw when your clinic collects the sample, or leave it unchecked for a PSC draw. It's unavailable for Pay at service center orders.
• Collected on – For In-office draws, it's filled in with the current date and time; adjust it if needed. On a Pay in clinic order with an In-office draw, a phlebotomy fee is added automatically when it's turned on in your Billing Settings. This fee can be adjusted or removed during order creation and will appear on the patient’s invoice along with the lab charges.

The more options menu (⋮) on the draft order holds:

• Add note to provider – Add an optional note that will be sent with the order
• Set expected on – For PSC draws, optionally enter the expected patient visit date to the PSC
• Add phlebotomy fee – Add the fee by hand on a Pay in clinic order

Step 4: Send the Lab Order

• Pay in clinic orders – Click Send order once pricing is complete
• Pay at service center orders – Click Send order. The patient's primary guarantor is added to the order automatically.
• Use insurance orders – Click Continue
  • Select Primary Coverage
  • Check Add additional coverage to include secondary or tertiary insurance, if applicable.
  • Select the Guarantor
  • Click Send order to finalize

Step 5: Print or Download the Requisition

After submission, you’ll be taken to the requisition view screen.

Here, you can:

• Download or Print the requisition
• View and print or download the label via the Label tab, when the provider sends one

Can I Edit the Order After it is Transmitted?

No. Once submitted, orders cannot be modified in SigmaMD. To make changes, please contact the diagnostic provider directly.