Urinalysis with Microscopic Reflex, if indicated

Test Code
LAB1230451


CPT Codes
81003

Includes
Color, Appearance, Specific Gravity, pH, Protein, Nitrite, Glucose, Leukocyte, Ketones, Blood, Urobilinogen, Bilirubin.


Minimum Volume
6 mL urine(Adult)


Other Acceptable Specimens
BD 16 X 100mm X 8ml vacutainers conical plastic yellow top UA tube.


Transport Temperature
Refrigerated


Specimen Stability
Ambient: 2 hours
Refrigerated: 24 hours


Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)
Contaminated sample or a sample that has been at room temperature more than 2 hours.


Methodology
Macroscopic
JMC:  Cobas u411
BMC:  Iris or Clinitek Advantus

Microscopic
JMC: Manual
BMC: Iris or Manual

Setup Schedule
Sunday-Saturday


Reference Range
Normal Macroscipic Values
Test BMC JMC
Color Yellow Yellow
Appearance Clear Clear
Specific Gravity <1.022 1.005-1.020
pH <8.0 5.0-7.5
Protein Negative Negative
Ketone Negative Negative
Bilirubin Negative Negative
Blood Negative Negative
Leukocytes Negative Negative
Glucose Negative Normal
Urobilinogen ≤2.0 ≤2.0
Nitrite Negative Negative
Normal Microscopic Values
RBC 0-2/hpf 0-2/hpf
WBC 0-2/hpf 0-5/hpf
Crystals 0-3/hpf 0-3/hpf
Sperm None None
Fat None None
Trichomonas None None
Yeast None None
Bacteria None None
Squamous Epithelial Cells 0-2/hpf 0-2/hpf
Hyaline Casts 0-2/hpf 0-2/hpf
Casts None None


Clinical Significance
Reflex to Microscopic Urinalysis will occur if there is a presence of blood, protein, nitrite, leukocyte esterase, or if there is color interference, or a clarity other than clear.


Performing Laboratory
Berkeley Medical Center
Jefferson Medical Center




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.