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Test Code 8705 Urinalysis Reflex to Microscopic without Culture (Urine Macroscopic with Reflex Microscopic, if Indicated) UA Reflex

Performing Laboratory

Barnes-Jewish Hospital Laboratory

Methodology

Testing Algorithm:

If there are abnormal dipstick findings (protein ≥+1, any blood, nitrite, or leukocyte esterase), then #3117 Urine Microscopic will be performed (if one has not been performed within the past 2 hours), at an additional charge.

Method Name:

Dipstick: Spectrophotometric reflectance of light on color reagent pads

Urine color: Spectrophotometry or visual observation

Specific gravity: Refractometry

Clarity: Measurement of the transmission and scatter of light

Includes color, clarity, specific gravity, pH, protein, glucose, ketones, bilirubin, occult blood, urobilinogen, nitrites, and leukocyte esterase.

Literature References:

1. Henry JB, et al. Clinical diagnosis and management by laboratory methods. 20th ed. Philadelphia, PA: Saunders, 2001:371-85.
2. Package insert: iChem Velocity Urine Chemistry Strips 2016

Specimen Requirements

Specimen Type: Urine, random

Container/Tube: Yellow-top, conical urine collection tube or Urine Complete Cup Kit

Specimen Volume: Full tube

Specimen Minimum Volume: 10 mL (3 to 8 mL specimen will be analyzed, however results may be modified by comment “<8 mL of urine received; normal range is based on 8 mL”)

Collection Instructions:

1. No additive.

2. Collect a midstream voided specimen.

3. Using cannula in collection cup lid, fill yellow-top, plastic, conical tube.

Additional Information:

1. Label tube with patient’s name and date of birth.

2. A catheterized specimen is acceptable.

3. Provide collection date and time, and method of collection.

4. If storage and transport is >1 hour, refrigerate specimen.

5. Specimen should be received in the laboratory within 1 hour of collection. Specimen >12 hours old will not be tested, except for non-hospital specimen having physician approval.

Day(s) Test Set Up

Monday through Sunday

Turnaround Time:

Urinalysis: STAT: 1 hour after receipt in laboratory

Routine: 2-4 hours after receipt in laboratory

Urine culture: see individual test listing

Reference Values

Specific gravity: 1.003-1.030
pH: 5.0-8.0
Protein: negative-trace
Glucose, qualitative: negative
Ketones, qualitative: negative
Bilirubin, qualitative: negative
Occult blood: negative
Urobilinogen: <2.0 mg/dL
Nitrites: negative
Leukocyte esterase: negative

See individual test listing for other reference values.

Literature References:

1. Henry JB, et al. Clinical diagnosis and management by laboratory methods. 20th ed. Philadelphia, PA: Saunders, 2001:1432-34.
2. Brunzel NA. Fundamentals of urine and body fluid analysis. 2nd ed. Philadelphia, PA: Saunders, 2004:419.

Test Classification and CPT Coding

81003-Urine macroscopic

81005-Urine qualitative/semi quantitative (if appropriate)

81015-Urine microscopic (if appropriate)

Additional Information

For BJH Laboratory Use Only

Alternate Tube(s):

1 non-sterile, plastic urine container

1 plain, red top tube

Analyte Stability:

Specimen should be received in the laboratory within 1 hour of collection. Specimen >12 hours old will not be tested, except for non hospital specimen having physician approval.

Laboratory Processing Instructions:

If specimen is received in a cup, lab processing personnel should use the cannula in the lid to transfer the urine to a yellow top tube before transporting to the UA tech. Test performed in BJH Hematology. Performed on uncentrifuged urine. If there are abnormal dipstick findings (protein ≥ +1, any blood, nitrite, or leukocyte esterase), a urine microscopic exam will be performed if 1 has not been performed within the past 2 hours.

Specimen Transport Temperature

Ambient <1 hour

Refrigerate >1 hour OK

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