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Test Code UA w C&S if Ind U C&S IF MICRO INCLUDED

Aliasis

UA with Microscopic

Patient Preparation

The first morning specimen collected by clean catch technique is preferred. Routine urine collection or in certain circumstances collection by catheter, specimen collection bag for pediatric specimens, or cystostomy is acceptable.

Ten (10) to 12 mL of cleanly voided or catheterized urine.

Urine should be collected in a sterile container

Special Collection Instructions

Male Patient Instructions for Midstream Clean Catch Urine Collection
1. You will be provided with a sterile specimen container and cleansing towelettes.
2. Wash hands with soap and water.
3. Remove the lid of the specimen container and place it on the counter, top side down. To maintain sterility, do not touch the inside of the urine collection container or the underside of the lid.
4. Open a towelette package, unfold the towel completely and cleanse the end of the penis, using a circular motion. Begin at the urethral opening and work away from it, using two to three towelettes. If uncircumcised, retract the foreskin and clean thoroughly.
5. While holding foreskin retracted (if applicable), start to urinate in toilet.
6. As you continue to urinate, pick up the container, being careful not to touch the inside of it, and bring it into the stream of urine to collect the sample.
7. Finish urinating into the toilet.
8. Place the lid tightly on the urine container. Wipe excess urine off outside of container with a paper towel.
9. Wash hands with soap and water.
10. Place urine specimen in the basket outside of the restroom or other location designated by the Clinical Laboratory Technician

Female Patient Instructions for Midstream Clean Catch Urine Collection
1. You will be provided with a sterile specimen container and cleansing towelettes.
2. Wash hands with soap and water.
3. Remove the lid of the specimen container and place it on the counter, top side down. To maintain sterility, do not touch the inside of the urine collection container or the underside of the lid.
4. Start with 3 towelettes. Open one and unfold the towelette completely. Use this to clean the vulva from front to back on the left side. Use the second towel the repeat the process on the right side, and the third towel to clean from front to back down the center of the urinary opening.
5. While holding labia apart, begin to urinate in the toilet.
6. As you continue to urinate, pick up the container, being careful not to touch the inside of it, and bring it into the stream of urine to collect the sample.
7. Finish urinating into the toilet.
8. Place the lid tightly on the urine container. Wipe excess urine off outside of container with a paper towel.
9. Wash hands with soap and water.
10. Place urine specimen in the basket outside of the restroom or other location designated by the Clinical Laboratory Technician.

Collection Method

Urine collection

Minimum Volume

5.0 mL

Container

Urine: Sterile container

Preferred Specimen

Urine: Sterile container

Acceptable Specimen(s)

Urine: Sterile container

Reference or Target Ranges

Color

Yellow

Clarity

Clear

Specific Gravity

1.006 – 1.035

pH

4.5 – 8.0

Bilirubin

Negative

Ketones

Negative  mg/dL

Glucose

Negative  mg/dL

Protein

Negative  mg/dL

Urobilinogen

0.2 – 1.0 EU

Blood

Negative

Leukocytes

Negative

Microscopic

 

RBCs

0 – 2 / HPF

WBCs

0 – 3 / HPF

Squamous Epithelial

None seen (Neg) to Few

Hyaline Cast

0 – 2 / HPF

Bacteria

Negative

All other microscopics

None Seen (Negative)

Critical Value

Babies (<1 year)

Positive Ketones and/or Glucose

Reasons for Rejection

Other:                

Contamination, Improperly labeled, Improper specimen type, Improper container, Color Interferences (e.g. AZO, Pyridium)

Specimen Stability

Ambient

2 Hours

Refrigerated         

24 Hours

Performance Information

Days and Time Performed

24/7

Expected Turn Around Time

Stat: 1 Hour, Routine: 4 Hours

Stat Availability

Yes

Performing Bench

CRMC Urinalysis

Methodology/Method Description

Iris

Additional Information / Important Notes

< 3.0 mL of sample may result in QNS for microscopic testing.

Reflex cultures indicated for:

  • WBCs: > 6/HPF
  • Bacteria: Few or > for males, Moderate or > for females
  • -Yeast: > Rare
  • If the epithelial count is > 20/LPF, the C urine will be cancelled and the comment "This specimen is inappropriate for reflexed culture. Please submit new specimen and new order if culture is desired."

Special Handling

Microscopy is performed on iQ200 Analyzer or manually by microscope when indicated

Methodology/Method Description

iRIS

  • Bilirubin: This test is based on the coupling of bilirubin and diazonium salt in an acidic medium. A pinkish tan color proportional to bilirubin concentration is generated.
  • Urobilinogen: This test is based on the coupling reaction of urobilinogen with a stable diazonium slat in buffer. A pink to red color proportional to the urobilinogen concentration is generated.
  • Ketone: This test is based on Legal’s method in which the test pad contains sodium nitroprusside and glycine in an alkaline medium. A violet color proportional to methylketone is generated.
  • Glucose: This two-step enzymatic reaction uses glucose oxidase, peroxidase and a chromogen. Glucose oxidase catalyzes the formation of gluconic acid and hydrogen peroxide via the oxidation of glucose. Peroxidase then catalyzes the reaction of hydrogen peroxide with a chromogen via the oxidation of chromogen to colors ranging between green and gray-blue.
  • Protein: This test is based on the “protein error of pH indicators” on the green color developed from the presence of protein. This dye-binding is particularly strong with albumin.
  • Blood: This pseudo-enzymatic test contains organic peroxide and a chromogen. The peroxidase effect of hemoglobin and myoglobin causes a color change to green.
  • pH: This test contains a mixed indicator which assures a marked change in color between pH5 and pH9. Colors range from orange through yellow and green to cyan.
  • Nitrite: This test is based on modified Griess reaction in which nitrite in the urine reacts with amide to form a diazonium compound. The subsequent coupling reaction yields a pink color in the presence of nitrite. Some Gram positive and non-nitrite-forming bacteria are not detected in this test.
  • Leukocytes: This enzymatic test pad contains an indoxyl ester and a diazonium salt. Granulocyte esterases react with indoxyl ester and diazonium salt to generate a violet color.U236

CPT Codes

81001

See reflex testing for additional billing