Epic Code LAB348 Urinalysis (UA) with Reflex to Culture if Positive (Outpatient Only)
Test Name Alias
Urinalysis, Culture if Indicated | UA | Urine C&S | UA do if | Urinalysis w/Micro Exam, C&S if Indicated | 115
Interface Order Alias
10540
Clinical Information
Refrigeration of urine inhibits bacteria growth but does not prevent the lytic effects of low specific gravity or alkaline pH. Urine crystal formation may be induced by refrigeration.
Ordering Instructions
Please do not order UA do if and Urine culture together. UA do if will reflex to Urine Culture if necessary. Please indicate source, i.e. ccms, nephrostomy, straight catheter.
This test is only available for outpatient ordering.
Effective 11/17/2021: When an order for Urine Culture [LAB239] and Urinalysis, do Culture if indicated [LAB348] is placed in the same encounter, these labs will update at the time of collection to an order for Urine Culture [LAB239] and Urinalysis [LAB2111180] to decrease duplicate urine cultures.
Icons & Photos
Collection Instructions
Specimen Collection: Urine (Clean Catch Mid-Stream/CCMS or Straight Catheter)
Container(s): 2 Pale Yellow Top Urine Tubes (UA No Additive) AND 1 Gray top urine C&S tube (contains boric acid)
Acceptable container: Sterile Cup AND 1 Gray top Urine C&S tube (contains boric acid)
Preferred Volume to Collect: 24 mL (2 × 10 mL Yellow and 1 × 4 mL Gray)
Minimum Volume to Collect: 4.0 mL
Neonate Volume to Collect: 3.0 mL
Collection Instructions:
- No preservatives
- Clean Catch Mid-Stream or Straight Catheter Collection.
- Ambient specimen must be received in the Lab within 2 hours.
- If delay: Keep the specimen refrigerated and send to laboratory as soon as possible.
- Specimen must be received in laboratory for analysis within 24 hours of collection.
- Gray vacutainer is to be used for Culture and Sensitivity (C&S).
Unacceptable
Specimens with 10 or more squamous epithelial cells are not appropriate for culture, a CCMS or catheterized may be indicated if culture is requested.
Processing Instructions (Laboratory, Outpatient or Off-site collection)
- If available, two barcode labels will print at the time of collection. Apply one label to the container and place the second label in the pouch of the specimen bag.
- Transport Temperature:
- Ambient: Gray top tube, Yellow Tube
- Refrigerate: Sterile cup
Rejection Criteria
Specimens that do not meet Spectrum Health Laboratory standards may be rejected (cancelled) due to:
- Request a repeat specimen when there is no evidence of refrigeration for a sterile cup collection and the specimen is greater than 2 hours old.
- Foley catheter tips/bags
- Catheter bags
- Leaky containers
- Non-sterile container (example: pill bottles or household containers)
Specimen Stability
2 Yellow top tubes and Urine Cup:
Ambient: 2 hours
Refrigerate: 24 hours
Laboratory Retention: 3 days
Gray top tube:
Ambient: 48 hours
Refrigerate: 48 hours
Laboratory Retention: 3 days
Reflex Information
- Culture and Sensitivity (C&S) will be performed with 2 or more of the following abnormal findings, provided there are less than 10 squamous epithelial cells per HPF:
- Greater than or equal to 10 WBC
- Positive leukocyte esterase
- Positive nitrite
OR if the specimen is:
- Grossly bloody
- Specimens with 10 or more squamous epithelial cells, culture will not be performed
- Culture and Sensitivity (C&S) will be performed if volume is inadequate for microscopic exam and Urinalysis (UA) with one or more of the following abnormal findings:
- Positive leukocyte esterase
- Positive nitrate
- If urinalysis is negative, culture will not be performed.
Test Frequency
Available 24 hours, usual TAT 1 day
Reference Range
Urinalysis (UA) is always performed first
Color | Yellow/Straw |
Clarity | Clear |
Glucose | Negative |
Bilirubin | Negative |
Ketone | Negative |
Sp Gravity | 1.010-1.030 |
Blood | Negative |
pH |
5.0-9.0 |
Protein | Negative |
Urobilinogen | Normal (0.2-1.0mg/dL) |
Nitrite(reductase) | Negative |
Leukocyte (esterase) | Negative |
Ictotest | Negative |
Mucus | None to Moderate |
Epithelial Cells | 0-9/HPF |
RBC’s | 0-3/HPF |
WBC’s | 0-5/HPF |
Bacteria/Yeast | None |
Amorphous |
None to Heavy |
Casts |
None (Few Hyaline may be normal) |
Parasites | None |
Trichomonas | None |
Urine Fat | None |
Crystals |
None (Some may be normal others pathogenic) |
Performing Department
URINES
Performing Department Laboratory Location
Spectrum Health Regional Laboratory, Grand Rapids, MI
Spectrum Health Big Rapids Laboratory, Big Rapids, MI
Spectrum Health Blodgett Laboratory, Grand Rapids, MI
Spectrum Health Gerber Laboratory, Fremont, MI
Spectrum Health Kelsey Laboratory, Lakeview, MI
Spectrum Health Ludington Laboratory, Ludington, MI
Spectrum Health Pennock Laboratory, Hastings, MI
Spectrum Health Reed City Laboratory, Reed City, MI
Spectrum Health United Laboratory, Greenville, MI
Spectrum Health Zeeland Laboratory, Zeeland, MI
Methodology
Methodology is available on request.
Please call the Laboratory Customer Service Call Center 616.774.7721 or send an email to LaboratoryServices@spectrumhealth.org
CPT
81001
This test is not limited to the CPT code(s) listed. Others may be added if culture and sensitivity is performed and if more testing is necessary depending on the pathogens isolated (such as MIC’s and ID’s).
CDM Code
4128715
Epic Test ID
1230101265
Beaker LOINC
U CHOLESTEROL CRYSTAL: 5777-8
U PATH: N/A
U SPERM.: N/A
U SRC: N/A
U XTAL: N/A
U YLC: N/A
URINE AMMONIUM BIURATE CRYSTAL: N/A
URINE AMORPHOUS CRYSTAL: 53329-9
URINE APPEARANCE: 32167-9
URINE BACTERIA: 25145-4
URINE BILIRUBIN CRYSTAL: 33236-1
URINE BILIRUBIN: 53327-3
URINE BLOOD: 57751-0
URINE CALCIUM CARBONATE CRYSTALS: 33241-1
URINE CALCIUM OXALATE CRYSTAL: 33234-6
URINE CALCIUM PHOSPHATE CRYSTALS: 33235-3
URINE COLOR: 50553-7
URINE CYSTINE CRYSTAL: 33240-3
URINE GLUCOSE: 2350-7
URINE HYALINE CASTS: 33223-9
URINE KETONES: 50557-8
URINE LEUCINE CRYSTAL: 50232-8
URINE LEUKOCYTE ESTERASE: 60026-2
URINE MICROSCOPIC: 12235-8
URINE MUCOUS: 53321-6
URINE NITRITE: 50558-6
URINE OVAL FAT BODIES: 50228-6
URINE PH: 50560-2
URINE PROTEIN: 50561-0
URINE RBC: 46419-8
URINE SPECIFIC GRAVITY: 50562-8
URINE SPERM: 33232-0
URINE SQUAMOUS EPITHELIAL CELLS: 33219-7
URINE TRICHOMONAS: 50237-7
URINE TRIPLE PHOSPHATE CRYSTAL: 33238-7
URINE TYROSINE CRYSTAL: 50238-5
URINE URIC ACID CRYSTAL: 33233-8
URINE UROBILINOGEN: 50563-6
URINE WBC: 46702-7
URINE WHITE BLOOD CELL CLUMPS: 53317-4
URINE YEAST: 72223-1
Reviewed Date
3/5/2020
Beaker Names
Beaker Procedure Name: URINALYSIS W/MICRO EXAM, C&S IF INDICATED
Beaker Display Name: Urinalysis (UA), Do Culture if Indicated
BEAKER TEST NAME: URINALYSIS, CULTURE IF POSITIVE
BEAKER TEST REPORT NAME: Urinalysis, Culture If Positive
Beaker Synonyms
No synonym on file
Beaker Collection and Specimen Handling
BEAKER COLLECTION: CC/Random+(1)R
Beaker Location, Container and Temperature
BW URINES: UR YELLOW/GREY (Preferred)-Refrigerated
BW URINES: 10 ML URINE YELLOW TUBE (Acceptable)-Refrigerated
BW URINES: 4 ML URINE GREY TUBE A (Acceptable)-Refrigerated
BW URINES: UR CUP/GREY (Acceptable)-Refrigerated
BW URINES: URINE CUP R (Acceptable)-Refrigerated
BL URINES: UR YELLOW/GREY (Preferred)-Refrigerated
BL URINES: 10 ML URINE YELLOW TUBE (Acceptable)-Refrigerated
BL URINES: 4 ML URINE GREY TUBE A (Acceptable)-Refrigerated
BL URINES: UR CUP/GREY (Acceptable)-Refrigerated
BL URINES: URINE CUP R (Acceptable)-Refrigerated
BR URINES: UR YELLOW/GREY (Preferred)-Refrigerated
BR URINES: 10 ML URINE YELLOW TUBE (Acceptable)-Refrigerated
BR URINES: 4 ML URINE GREY TUBE A (Acceptable)-Refrigerated
BR URINES: UR CUP/GREY (Acceptable)-Refrigerated
BR URINES: URINE CUP R (Acceptable)-Refrigerated
GM URINES: UR YELLOW/GREY (Preferred)-Refrigerated
GM URINES: 10 ML URINE YELLOW TUBE (Acceptable)-Refrigerated
GM URINES: 4 ML URINE GREY TUBE A (Acceptable)-Refrigerated
GM URINES: UR CUP/GREY (Acceptable)-Refrigerated
GM URINES: URINE CUP R (Acceptable)-Refrigerated
KL URINES: UR YELLOW/GREY (Preferred)-Refrigerated
KL URINES: 10 ML URINE YELLOW TUBE (Acceptable)-Refrigerated
KL URINES: 4 ML URINE GREY TUBE A (Acceptable)-Refrigerated
KL URINES: UR CUP/GREY (Acceptable)-Refrigerated
KL URINES: URINE CUP R (Acceptable)-Refrigerated
LH URINES: UR YELLOW/GREY (Preferred)-Refrigerated
LH URINES: 10 ML URINE YELLOW TUBE (Acceptable)-Refrigerated
LH URINES: 4 ML URINE GREY TUBE A (Acceptable)-Refrigerated
LH URINES: UR CUP/GREY (Acceptable)-Refrigerated
LH URINES: URINE CUP R (Acceptable)-Refrigerated
PH URINES: UR YELLOW/GREY (Preferred)-Refrigerated
PH URINES: 10 ML URINE YELLOW TUBE (Acceptable)-Refrigerated
PH URINES: 4 ML URINE GREY TUBE A (Acceptable)-Refrigerated
PH URINES: UR CUP/GREY (Acceptable)-Refrigerated
PH URINES: URINE CUP R (Acceptable)-Refrigerated
RC URINES: UR YELLOW/GREY (Preferred)-Refrigerated
RC URINES: 10 ML URINE YELLOW TUBE (Acceptable)-Refrigerated
RC URINES: 4 ML URINE GREY TUBE A (Acceptable)-Refrigerated
RC URINES: UR CUP/GREY (Acceptable)-Refrigerated
RC URINES: URINE CUP R (Acceptable)-Refrigerated
UN URINES: UR YELLOW/GREY (Preferred)-Refrigerated
UN URINES: 10 ML URINE YELLOW TUBE (Acceptable)-Refrigerated
UN URINES: 4 ML URINE GREY TUBE A (Acceptable)-Refrigerated
UN URINES: UR CUP/GREY (Acceptable)-Refrigerated
UN URINES: URINE CUP R (Acceptable)-Refrigerated
ZH URINES: UR YELLOW/GREY (Preferred)-Refrigerated
ZH URINES: 10 ML URINE YELLOW TUBE (Acceptable)-Refrigerated
ZH URINES: 4 ML URINE GREY TUBE A (Acceptable)-Refrigerated
ZH URINES: UR CUP/GREY (Acceptable)-Refrigerated
ZH URINES: URINE CUP R (Acceptable)-Refrigerated