Urinalysis, Reflex

Cassandra Greaves Test, U

NEW YORK DOH APPROVED: YES

CPT Code: 81003 (If reflexed to Microscopic, CPT Code becomes 81001)
Order Code: 1382
Includes: Color, Turbidity, Glucose, Bilirubin, Ketones, Specific Gravity, Hemoglobin/Blood, pH, Protein, Urobilinogen, Nitrite, and Leukocyte Esterase. If the urinalysis test reflexes to microscopic examination, the CPT code will become 81001 (Urinalysis, Complete) for the collective of tests which will require an additional charge
ABN Requirement: 
No
Synonyms: Urinalysis with Reflex to Microscopic Exam
Specimen: Urine, Random
Volume:  8.0 mL
Minimum Volume:  3.0 mL
Container: Urine Specimen Preservative Tube (Cherry Red/Yellow Top or Stockwell Tube)

Collection:

  1. Collect urine sample according to standard protocols.
  2. Transfer aliquot from a clean urine cup into a urine specimen tube using the vacutainer transfer device included with the tube.
  3. Gently invert tube 8-10 times.
  4. Label tube according to standard protocols.

Patient Preparation: Patient should be instructed to collect a “clean-catch, midstream” urine specimen.

Transport: Store urine at 2°C to 8°C after collection and ship the same day per packaging instructions provided shipping box.

Stability:

Ambient (15-25°C): 2 hours
Refrigerated (2-8°C): 72 hours
Frozen (-20°C): not acceptable

Causes for Rejection: Specimens other than urine sample in a preservative tube; improper labeling; samples not stored properly; samples older than stability limits; grossly bloody or mucoid samples.

Methodology: Colorimetric/Automated Microscopic (if reflexed)

Turn Around Time: 1 to 3 days

Limitations: Unusually colored urine due to medication, azo dyes (Pyridium, Azo Gantrisin, and Azo Gantanol) or riboflavin may interfere with any of the urine tests below.

Reference Range: See below

Macroscopic ElementsReference Range
ColorColorless to Dark Yellow
TurbidityClear
Glucose< 30 mg/dL
Bilirubin< 0.5 mg/dL
KetonesNegative
Specific Gravity1.005-1.035
Hemoglobin/BloodNegative
pH5.0-8.0
Protein≤ 20 mg/dL
Urobilinogen< 2 mg/dL
NitriteNegative
Leukocyte Esterase< 25 Leu/uL
Microscopic ElementsReference Range
WBC0-5 cells/HPF
RBC0-2 cells/HPF
Epithelial Cells0-5 cells/HPF
BacteriaNone HPF
Hyaline Casts< 10 cells/LPF

Clinical Significance: Dipstick urinalysis measures chemical constituents of urine. Microscopic examination helps to detect the presence of cells, bacteria, yeast and other formed elements.

The CPT codes provided 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 payer being billed.