Purpose and Completion Standard
Use this guide after the practice approves the three-category In-House Lab structure. Implementation is complete when every applicable PIMS service and inventory item is classified by diagnostic methodology, direct costs are mapped to the corresponding COGS account, and the supplemental accounts reconcile to the standard 5301 In-House Lab Revenue and 6301 In-House Lab COGS parent accounts.
Revenue accounts 5311, 5312, and 5313 sum to 5301 In-House Lab Revenue.
COGS accounts 6311, 6312, and 6313 sum to 6301 In-House Lab COGS.
The same methodology rule is used in the PIMS, QuickBooks, and management reports.
New and ambiguous items have an assigned owner and a documented resolution process.
Implementation Assistance from VizVet
VizVet can assist with this implementation when VizVet has access to the practice's PIMS data. VizVet can extract or review the complete In-House Lab service and inventory-item list, propose diagnostic categories and supplemental GL mappings, identify exceptions, and prepare the companion mapping worksheet. The practice's authorized PIMS, clinical, and accounting leaders approve the classifications and complete the system changes.
Target Account Structure
Diagnostic category | Revenue | COGS | Classification anchor |
|---|---|---|---|
Manual In-House Diagnostics | 5311 | 6311 | Microscopy or direct examination with minimal equipment or consumable testing devices |
Point-of-Care Testing | 5312 | 6312 | Single-use kits, ELISA-based assays, lateral-flow devices, cartridges, or cassettes |
In-House Analyzer Diagnostics | 5313 | 6313 | Automated or semi-automated analyzers operated within the practice |
Classify by how the test is performed, not by its medical purpose. Specimen-collection revenue and direct supplies follow the diagnostic method they support. Tests performed by an external laboratory remain Outside Lab.
Implementation Record
Field | Practice entry | Field | Practice entry |
|---|---|---|---|
Practice | Effective date | ||
PIMS | Accounting system | ||
Executive sponsor | Clinical reviewer | ||
PIMS owner | Finance owner |
Phase 1 Prepare and Approve
Done | Implementation task | Completion evidence |
|---|---|---|
☐ | Name the executive sponsor, PIMS owner, finance owner, and clinical reviewer. | Owners entered above |
☐ | Approve the three definitions and one decision rule for every participating practice. | Approved coding standard |
☐ | Choose the effective date and decide whether prior periods will remain unchanged or be reclassified. | Written effective-date decision |
☐ | Export the active PIMS service and inventory-item list with current GL mappings and recent revenue. | Dated PIMS export |
☐ | Export the chart of accounts and current In-House Lab revenue and COGS detail. | Dated accounting export |
☐ | Collect recent vendor invoices, product lists, credits, and recurring entries for lab purchases. | Source packet assembled |
☐ | Preserve the source exports before changing mappings. | Read-only baseline retained |
☐ | If VizVet implementation assistance is requested, provide VizVet with access to the practice's PIMS data or a complete PIMS export. | PIMS data access confirmed |
Phase 2 Configure QuickBooks
Done | Implementation task | Completion evidence |
|---|---|---|
☐ | Confirm that 5301 In-House Lab Revenue and 6301 In-House Lab COGS are the standard parent accounts. | Parent accounts confirmed |
☐ | Create revenue subaccounts 5311 Manual, 5312 POCT, and 5313 Analyzer beneath 5301. | Three revenue subaccounts |
☐ | Create COGS subaccounts 6311 Manual, 6312 POCT, and 6313 Analyzer beneath 6301. | Three COGS subaccounts |
☐ | Use consistent account names and numbering across affiliated practices. | Shared account list |
☐ | Map recurring vendor entries and known product groups to the appropriate 6311, 6312, or 6313 account. | Vendor mapping list |
☐ | Record line items from mixed invoices in the appropriate COGS accounts rather than assigning the entire invoice to one category. | Mixed-invoice procedure |
☐ | Return credits, rebates, and purchase corrections to the category of the original cost using the practice's accounting policy. | Credit handling documented |
☐ | Run a test profit and loss report to confirm the six supplemental accounts roll up to 5301 and 6301. | Test P&L retained |
Phase 3 Classify and Update PIMS Items
Done | Implementation task | Completion evidence |
|---|---|---|
☐ | Review every active In-House Lab service code and each inventory item tied to it. | Complete item inventory |
☐ | Assign manual procedures such as cytology, microscopic urinalysis, blood smears, PCV or total solids, and skin scrapings to 5311. | Manual items coded |
☐ | Assign rapid kit-based tests such as SNAP and similar single-use assays to 5312. | POCT items coded |
☐ | Assign CBC, chemistry, electrolytes, automated urinalysis, blood gas, and other analyzer-based services to 5313. | Analyzer items coded |
☐ | Confirm that specimen-collection charges follow the diagnostic category they support. | Collection mapping reviewed |
☐ | Confirm that tests performed outside the practice remain mapped to Outside Lab. | Outside Lab exceptions resolved |
☐ | Review bundles and profiles that combine methods; split components when the PIMS supports it or document one consistent treatment rule. | Bundle policy documented |
☐ | Reclassify the PIMS service and inventory items to the approved revenue accounts. | Updated PIMS mapping export |
☐ | Establish a required category field or review step for every new lab item created after go-live. | New-item control active |
Phase 4 Map Direct Costs
Done | Implementation task | Completion evidence |
|---|---|---|
☐ | Map slides, stains, collection containers, needles, syringes, and other manual diagnostic consumables to 6311 when directly attributable. | Manual cost mapping |
☐ | Map rapid test kits, cartridges, cassettes, ELISA-based assays, and lateral-flow devices to 6312. | POCT cost mapping |
☐ | Map analyzer reagents, calibrators, controls, and analyzer consumables to 6313. | Analyzer cost mapping |
☐ | Map specimen-collection supplies to the diagnostic category they support when they are directly attributable. | Collection costs reviewed |
☐ | Split mixed vendor invoices by product line and preserve the original invoice support. | Sample invoices verified |
☐ | Document temporary handling for products that cannot yet be separated and assign an owner and resolution date. | Exception log updated |
☐ | Apply freight, sales tax, service arrangements, and other indirect or shared charges consistently under the practice's accounting policy. | Accounting treatment approved |
Phase 5 Reconcile and Validate
Done | Implementation task | Completion evidence |
|---|---|---|
☐ | Confirm that 5311 plus 5312 plus 5313 equals the consolidated 5301 In-House Lab revenue total for the test period. | Revenue reconciliation |
☐ | Confirm that 6311 plus 6312 plus 6313 equals the consolidated 6301 In-House Lab COGS total for the test period. | COGS reconciliation |
☐ | Trace at least three transactions from each category from the PIMS or invoice through the general ledger. | Transaction test retained |
☐ | Investigate zero or unusually low COGS before concluding that a category has minimal cost. | Missing-cost review |
☐ | Review credits, returns, inventory timing, expired tests, and uncharged reruns that may affect the first reporting periods. | Timing and waste review |
☐ | Document all unresolved items, the temporary treatment, responsible owner, and target resolution date. | Exception log complete |
Phase 6 Go Live and Maintain
Done | Implementation task | Completion evidence |
|---|---|---|
☐ | Approve the effective date after the PIMS, accounting, and reconciliation tests pass. | Go-live approval |
☐ | Provide the coding guide to managers, PIMS administrators, bookkeepers, and clinical reviewers. | Training completed |
☐ | Restrict or review new service, inventory, vendor, and GL mappings before use. | Change control assigned |
☐ | Reconcile the six supplemental accounts to 5301 and 6301 each month. | Monthly reconciliation |
☐ | Review new and unmapped items, credits, missing costs, and exceptions each month. | Monthly exception review |
☐ | Review modality-level COGS quarterly for changes in price, expiration, reruns, waste, utilization, and inventory control. | Quarterly management review |
☐ | Review definitions, analyzer platforms, test menus, vendors, and ownership annually or whenever operations change. | Annual governance review |
Validation and Sign Off
Validation | Result | Reviewer | Date |
|---|---|---|---|
PIMS mappings complete | Pass / exception | ||
QuickBooks accounts and mappings complete | Pass / exception | ||
5301 revenue roll-up reconciles | Pass / exception | ||
6301 COGS roll-up reconciles | Pass / exception | ||
Go-live approved | Approved / deferred |
Interpretation After Go Live
Do not treat the first modality-level COGS results as a benchmark until revenue and costs are complete for the same period. Early results may reflect opening inventory, purchase timing, missing invoice detail, credits, or incomplete historical mapping. Preserve the practice's consolidated trend while the new detail matures, then compare manual with manual, POCT with POCT, and analyzer with analyzer.