Sign in →

Epic Test Code Lab21023 Pediatric Urinalysis with reflex to Culture

Important Note

For Patients 18 years and younger

Performing Location(s)

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

Synonyms

Macroscopic and Microscopic Urinalysis

Specimen Type

Random Urine

Preferred Container

Sterile Cup

Volume Required

12 mL

Minimum Volume

1 mL

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 hour 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 values are 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

 

Microscopic
Parameter Population Units Reference Range
RBC's All populations #/hpf 0-2
WBC's All populations #/hpf <6
Squamous Epithelium All populations #/hpf <4
Transitional Epithelium All populations #/hpf 0-3
Bacteria All populations #/hpf 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  ( Pediatric [<18yrs] only).
  Ketones > 40 mg/dL (Pediatric [<18yrs] only).
 

 

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

 

Reflex testing

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.

 

 

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. Microscopic examination of the urine or urine sediment.

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

Suggest early morning first voided urine for maximum concentration of urine analytes and formed elements.

Methodology

Microscopic:Manual microscopy, automated using flow cyotmetry and fluorescence

Macroscopic: Urine reagent strip

Automated testing

CPT Code

81001

Last Updated

12-May-21 BHD