Urinalysis with Reflex to Microscopic

Test Code

7909

CPT Codes
81003

Includes

A microscopic examination is performed, when appropriate, at an additional charge (CPT code(s): 81015).

Preferred Specimen

10 mL urine - Urinalysis transport tube (yellow-top, blue fill line, preservative tube)

Minimum Volume

Preserved: 3 mL
Unpreserved (pediatric only): 1 mL

Other Acceptable Specimens

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

Instructions

Encourage midstream samples to minimize contamination and improve accuracy. Label the sample appropriately and store at room temperature until pick-up.

Note: The yellow-top, blue line tube cannot be used for collection and transport of specimens for urine culture.

**This test code does not include reflex to culture**
If reflex to culture is desired, please order "Urinalysis, Complete, with Reflex to Culture" (test code 3020).
If culture is being ordered separately, submit separate specimen (4 mL gray-top tube).

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/Microscopic Examination if urine macroscopic or dipstick indicates

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 measures chemical constituents of urine. Microscopic examination helps to detect the presence of cells, bacteria, yeast and other formed elements.

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.