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.