Cytology, Urine

Message

Not orderable in Meditech. Please complete paper Pathology Requisition and send with sample
Label specimen container with patient's complete first and last name, date of birth, date and time of collection, and specimen source.
For outpatients order a CYTOPATH. In comments enter "SOURCE URINE"

Test Code

AP014

Alias/See Also

Urine, Bladder Washings/Lavage

CPT Codes
88112

Preferred Specimen

Second morning specimen; voided or catheterized urine; intraoperative washings of urinary bladder, urethra, ureters, or renal pelvis

Prefer specimen submission in CytloLyt (1 part fixative to 3 parts specimen)

Collection

Have patient drink one glass (6 oz) every 15 minutes for 2 to 3 hours. At the end of 2 hours, have the patient void or catheterize. Discard specimen.

Technique I (routine): One hour after collection of discarded specimen, have patient void and save the specimen. Send labeled specimen to the laboratory immediately.

Technique II (when residual bladder urine is present): Thirty minutes to 1 hour after collection of discarded specimen, catheterize bladder. Send labeled specimen to the laboratory immediately.

Technique III (for detection of upper urinary tract lesions): Catheterize ureters to pelvis for suspected renal or pelvic lesions. Repeat procedure using either ureter for control. For ureteral lesion, catheterize ureter to a point just below the level of the suspected lesion. Catheterize other ureter for control. Collect urine for 30 minutes. Label appropriately, right and left ureteral or pelvic specimen. Ship specimen immediately to the laboratory.

Patient Preparation
Hydrate patient (give several glasses of water 30 minutes to 1 hour prior to collection).

Minimum Volume

50 mL

Instructions

Have patient drink one glass (6 oz) every 15 minutes for 2 to 3 hours. At the end of 2 hours, have the patient void or catheterize. Discard specimen.

Technique I (routine): One hour after collection of discarded specimen, have patient void and save the specimen. Send labeled specimen to the laboratory immediately.

Technique II (when residual bladder urine is present): Thirty minutes to 1 hour after collection of discarded specimen, catheterize bladder. Send labeled specimen to the laboratory immediately.

Transport Container

Sterile plastic urine container.

Transport Temperature

Room Temperature

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

Improper labeling; improper fixation; 24-hour collection; undue delay in transport; specimen submitted in vial that expired according to manufacturer's label; frozen specimen

Methodology
The fluid will be centrifuged, supernatant poured off, and diagnostic cells aspirated from the remaining material. Filters, monolayers, and/or cytospins will be made along with a cell block, if applicable. Microscopic examination is performed.

Limitations

Low-grade papillary transitional cell or urothelial carcinomas may not be diagnosed by cytologic examination. Calculi or recent instrumentation may produce atypical changes in urothelial cells simulating malignancy. Chemotherapy and radiation may also produce changes stimulating neoplasia. Viral culture is the method of choice for the diagnosis of CMV but cytology can provide faster results.

Clinical Significance

Establish the presence of primary or metastatic neoplasms; aid in the diagnosis of infections with herpesvirus, cytomegalovirus, Blastomyces, and Schistosoma; evaluate malacoplakia; establish the presence of cytomegalic inclusion disease

Last Updated: April 7, 2021

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.