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Test Code 8707 Urinalysis Reflex for Neutropenic Patient (Urine Macroscopic with Reflex Microscopic and Culture, if Indicated) UA Flex C/S

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) and #M052 Culture, Routine, Aerobe will be performed 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 and 1 BD Vacutainer grey-top C&S Preservative Tube-Both tubes must be sent together.

Specimen Volume: Full tube

Specimen Minimum Volume:

Urinalysis: 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”)

Urine culture: 5 mL

Collection Instructions:

1. No additive.

2. Collect a midstream voided specimen following directions printed on outer wrapping of Urine Complete Kit.
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 listings 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)
87086-Culture, urine (if appropriate)

Additional Information

For BJH Laboratory Use Only

Alternate Tube(s):

1 plain, red-top tube

1 sterile, plastic urine container

Analyte Stability:

Urinalysis: 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 will use the cannula in the lid to transfer urine to yellow top and grey top tubes before transporting to the UA tech.

Test performed in BJH Hematology on uncentrifuged urine. Hematology will forward to BJH Microbiology if appropriate.  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 and the grey-top tube will be sent to microbiology for culture. Place an orange culture and sensitivity sticker on grey-top tube and send to microbiology for culture to be ordered. Microbiology will send all grey-top tubes without a sticker to hematology.

Specimen Transport Temperature

Ambient <1 hour

Refrigerate >1 hour OK