11800:URINALYSIS WITH MICROSCOPIC EXAM, CULTURE IF INDICATED

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11800:URINALYSIS WITH MICROSCOPIC EXAM, CULTURE IF INDICATED
Methodology: Automated Urine Chemistry (dipstick) Analyzer; Microscopic Exam, with manual review if flagged or abnormal
Edit Date: 4/5/2010
Performed: Daily
Released: Urinalysis: Same day. Culture: 48-72 hours.
CPT Code: 81001 / 87086 if indicated
Specimen Collection Details
Collection: Clean catch/midstream, catheter, cystoscopic, or suprapubic urine in a sterile plastic container. Do not submit syringes with needles attached.
Handling: Keep refrigerated. Send to the laboratory within 24 hours. If delayed, submit the specimen in a urinalysis preservative tube, available from Client Services. These special tubes are not designed for use with urine for urine culture.
Stability: 24 hours refrigerated or 72 hours preservative tube.
Standard Volume: 10 mL urine.
Minimum Volume: 6 mL urine (smaller volumes reported with disclaimer).
Transport: Refrigerated, or in urinalysis preservative tube.
Comments: Includes urinalysis with microscopic exam. Culture added if WBC >5 and/or Leukocyte Esterase positive and/or Nitrite positive. NOTE: In-house studies show that these screening parameters result in detection of most positive urine cultures (93% sensitivity). Some organisms do not elicit a typical UTI presentation (i.e., elevated WBC in the urine), and so may be missed by this reflex testing. If there is a strong initial clinical suspicion of UTI, or if symptoms persist despite normal screening test results, urine culture should be ordered rather than a reflex culture if indicated.
Rejection Criteria: Frozen specimen; fecal contamination; insufficient specimen; specimen submitted with needle attached; unpreserved specimen held longer than 24 hours.
MEDICARE MAY REQUIRE A SIGNED ADVANCE BENEFICIARY NOTICE (ABN) FOR THIS TEST

Reference Range
Specific Gravity 1.003-1.035
pH 5-8
Leukocyte Esterase, Nitrite, Protein, Glucose, Ketone, Urobilinogin, Bilirubin, Blood Negative
WBC 0-5/HPF
RBC 0-3/HPF
Bacteria 0-2+

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