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Epic Test Code LAB21014 Urinalysis, Routine with Urine Culture if Positive

Performing Location(s)

BMC,CRH,LFH,HRK,OCH,FTT,FOX

Synonyms

Urinalysis; UA

Specimen Type

Clean Catch or Catheterized Urine

Preferred Container

Sterile Urine Collection Container

Minimum Volume to Submit for Testing

5 mL Urine

Storage Requirements

See Causes of Rejection for temperature requirements.
May be refrigerated up to 24 hours

DO NOT USE CHEMICAL PRESERVATIVES

 

Transportation Needs

Deliver specimen to the laboratory within 1 hour of collection. If not possible see “Storage Requirements”

Causes for Rejection

Mislabeled or unlabeled specimen

Specimen received in container with Chemical Preservatives

>1 hrs room temperature

 > 24 hours refrigerated

Quantity insufficient for analysis

Interference by chromogen metabolite from certain antibiotics

Gross Hemolysis

Limitations

All tests may be unreliable if the specimen is grossly bloody or if the color of the urine is markedly affected by metabolites from certain antibiotics.

 

Glucose sensitivity is affected by concentrations of ascorbate greater than 50 mg/dl causing false negatives when patient samples lie between 75-125 mg/dL glucose.

 

Ketone bodies (40 mg/dL) may also reduce the sensitivity of the test for specimens containing small amounts of glucose (75-125mg/dL).

 

Specific gravity may be decreased with highly buffered urines

 

False positives for protein may be caused by highly buffered urines.

Reference Values

Macroscopic
Parameter Population Units Reference Range
Color All populations None Yellow, straw or colorless
Appearance All populations None Clear
Specific Gravity All populations None 1.003-1.024
pH All populations None 5.0-8.0
Protein All populations mg/dL Negative
Glucose All populations mg/dL Negative
Ketone All populations mg/dL Negative
Bilirubin All populations None Negative
Blood All populations None Negative
Urobilinogen All populations Eu/dL ≤ 1.0
Nitrite All populations None Negative
Leuk Esterase All populations None Negative

 

Microscopic
Parameter Population Units Reference Range
RBC's All populations #/hpf 0-2
WBC's All populations #/hpf <6
Squamous Epithelium All populations #/hpf <6
Transitional Epithelium All populations #/hpf 0-3
Bacteria All populations None None
Crystals All populations #/hpf None
Hyaline Casts All populations #/lpf 0-2
All Other Casts All populations #/lpf None
Critical Values:
  Glucose > 100 mg/dL  (Obstetric or pediatric [<18yrs] only).
  Ketones > 40 mg/dL (Obstetric or pediatric [<18yrs] only).

 

Reflex Testing

Algorithms used to determine testing and billing:

Urinalysis Testing and billing:

Only a macroscopic analysis (urine dipstick and gross visual inspection) is performed and CPT #81003 is billed if …..

The sample’s appearance is clear, and
The specimen is colorless, straw, yellow or amber, and
the urine Macroscopic analysis does not reveal an abnormality on any of the following dipstick tests:

Blood

Glucose

Leukocyte esterase

Nitrites

Protein

A macroscopic analysis and a urine  sediment microscopic examination is performed and CPT #81001 is billed if …..

The sample is cloudy, or if …..

The sample is brown, red, green or orange, or if ….

During the Macroscopic (reagent dipstick) analysis an abnormality is detected on any of the following tests:

Blood

Glucose

Leukocyte esterase

Nitrites

Protein

Urine Culture Testing and billing:(See Culture urine or Microbiology: Urine Culture for requirements):

 

The Urine Culture will be performed and CPT #87086 will be billed.if two out of three are present:  positive nitrites, positive leukocyte esterase and/or greater than ten WBC/hpf seen on the microscopic AND there are less than six squamous epithelial cells/hpf.

 

 

Reflex Testing Data

Days of Analysis

All

Available STAT

Yes

Includes

Reagent dipstick testing for urine glucose, protein, pH, specific gravity, ketones, bilirubin,urobilinogen, blood, nitrite, leukocyte esterase and gross visual examination for appearance and color.

A urine sediment microscopic examination will be performed as determined by the information found in the “Urinalysis Testing and billing” portion of the Reflex Testing Data section, below.

 

A urine culture will be performed and billed as determined by the information found in the “Urine Culture Testing and billing” portion of the Reflex Testing Data section, below.

Additional Information

Clean Catch Urine Collection

Methodology

Urine reagent strip

Automated testing

CPT Code

See Reflex Testing

Last Updated

22-July-22 BHD