It first describes the problems existing in the development process of the medical laboratory under the background of the Diagnosis-Intervention Packet (DIP) payment mode reform, such as the frequent discovery of illegal items related to inspection, the absence of some fee items, and the difficulty in reflecting the project cost and service value, and analyzes the causes of the above problems. It points out that the main reasons were lack of understanding of medical insurance violations or malicious fraud, limitations of DIP payment itself, and failure to timely declare or improve inspection fee items. Finally, it is suggested to carry out rationality as- sessment of the test items, timely declare the charge items to guarantee the compliance charge and control the test costs to support the sustainable development of the test discipline.