Urinalysis, Complete, with Reflex to Culture

Test Code

3020

CPT Codes
81001

Includes

Macroscopic and Microscopic Examinations

If any of the following Urinalysis results are applicable, then a culture will be performed at an additional charge (CPT code(s): 87086).
•Presence of Leukocyte esterase alone
•Presence of WBC's (>5/hpf) alone
•Presence of Yeast
•Presence of Bacteria and the presence of WBCs (>5/hpf) or Leukocyte esterase
•Presence of Nitrite and the presence of WBCs (>5/hpf) or Leukocyte esterase

If culture is positive, CPT code(s): 87088 (each isolate) will be added with an additional charge. Identification will be performed at an additional charge (CPT code(s): 87077 or 87140 or 87143 or 87147 or 87149).
Antibiotic susceptibilities are only performed when appropriate (CPT code(s): 87181 or 87184 or 87185 or 87186).

Preferred Specimen

Submit two separate specimens:
1) 10 mL urine submitted in urinalysis transport tube (yellow-top, blue fill line, preservative tube)
2) 4 mL (fill to minimum line printed on tube; unpreserved for cultures) urine in urine culture tube (gray-top) or UriSponge™ transport

Minimum Volume

Preserved (yellow-top, blue fill line): 3 mL
Urine in urine culture tube (gray-top): Must be filled to minimum line printed on tube
Completely saturated UriSponge transport
Unpreserved (culture): 0.5 mL
Unpreserved (pediatric only): 1 mL

Other Acceptable Specimens

3 mL (1 mL minimum) unpreserved pediatric urine • 10 mL (3 mL minimum) urine collected in yellow-red swirl-topped conical transport tube with preservative

Instructions

Encourage clean catch midstream samples to minimize contamination and improve accuracy. If sample is submitted unpreserved, please indicate that specimen is from pediatric patient (patient is less than or equal to 12 years of age). Label the sample appropriately. Unpreserved urine will be accepted from pediatric patients only.

Transport Temperature

Preserved: Room temperature
Pediatric unpreserved: Refrigerated (cold packs)

Specimen Stability

Preserved urine
Room temperature: 72 hours
Refrigerated: 72 hours
Frozen: Unacceptable

Unpreserved urine
Refrigerated: 24 hours - Pediatric specimen

Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)

Unpreserved specimen (adults)

Methodology
Reagent Impregnated Strips/Tablets

Setup Schedule

Set up: Daily; Report available: Next day

Reference Range

Color	Yellow
Appearance	Clear
Specific Gravity	1.001-1.035
pH	5.0-8.0
Glucose	Negative
Bilirubin	Negative
Ketones	Negative
Occult Blood	Negative
Protein	Negative
Nitrite	Negative
Leukocyte Esterase	Negative
WBC	≤5 /HPF
RBC	≤2 /HPF
Squamous Epithelial Cells	≤5 /HPF
Transitional Epithelial	≤5 /HPF
Renal Epithelial Cells	≤3 /HPF
Bacteria	None seen
Calcium Oxalate Crystals	None or Few
Triple Phosphate Crystals	None or Few
Uric Acid Crystals	None or Few
Amorphous Sediment	None or Few
Crystals	None seen
Hyaline Casts	None seen
Granular Casts	None seen
Casts	None seen
Yeast	None seen

Clinical Significance

Dipstick urinalysis is important in accessing the chemical constituents in the urine and the relationship to various disease states. Microscopic examination helps to detect the presence of abnormal urine cells and formed elements. Culture may identify the organism(s) causing infection.

The CPT Codes provided in this document are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payor being billed. Any Profile/panel component may be ordered separately. Reflex tests are performed at an additional charge.