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URCUL
CULTURE, BACTERIA, URINE

Test Code URCUL 
Test CULTURE, BACTERIA, URINE 
Methodology Conventional Culture 
Description Significant isolates reflex to organism identification and antibiotic susceptibility test at an additional charge.

NOTE: This test, when ordered on Medicare patients, is subject to the National Coverage Determination (NCD) policy "Urine Culture, Bacterial". Please verify that the diagnosis code (ICD-9) you have chosen demonstrates medical necessity for the test as documented in the physician's patient record. The CMS web site or the NorDx Limited Coverage Documentation Guide are available to assist you with this verification. A properly executed Advance Beneficiary Notice (ABN) must be submitted with the specimen if medical necessity is not demonstrated by the ICD-9 code chosen. 

Specimen Submit only 1 of the following specimens:

Collect first morning specimen when possible. Organisms accumulate in bladder overnight, so first morning specimen provides the best yield. Specimens collected at other times are more dilute and are not optimal.

CLEAN-CATCH, MIDSTREAM URINE

Male
1. Open the towelette packages, but do not remove towelettes until ready to use. Remove the cover from the specimen container. Do not touch the inside of the specimen container or lid at any time. Place towelettes and container where they can be reached while urinating.
2. With one hand, pull back the foreskin (if present) until specimen collection is complete.
3. Wash the end of the penis with the first towelette and discard the towelette in the toilet.
4. Repeat with second towelette.
5. Start to urinate into the toilet.
6. After the first few teaspoons, put the specimen container into the stream of urine and collect as much urine as possible. Fill the container 3/4 full if possible.
7. Screw the cover securely onto the specimen container.
8. Label container with patientís name (first and last), date of birth or medical record number, date and time of collection, and collectorís initials.
9. Fill urine culture transport tube to the line (or more) with the specimen and label as stated above.
10. Maintain sterility and forward urine culture transport tube promptly to laboratory at ambient temperature. (Alternative: If urine culture transport tube is not available, send specimen refrigerated in original screw-capped specimen container.)

NOTE: SPECIMEN SOURCE IS REQUIRED ON REQUEST FORM FOR PROCESSING.


Female
1. Open the towelette packages, but do not remove towelettes until ready to use. Remove the cover from the specimen container. Do not touch the inside of the specimen container or lid at any time. Place towelettes and container where they can be reached while urinating.
2. With one hand, spread open the folds of skin around urethra and vagina and hold open until specimen collection is complete.
3. Clean the area around urethra and vagina by wiping the left side once from front to back with the first towelette. Discard the towelette in the toilet.
4. Clean the right side by wiping once from front to back with the second towelette. Discard the towelette.
5. Clean the center by wiping once from front to back with the third towelette. Discard the towelette.
6. Start to urinate into the toilet.
7. After the first few teaspoons, put the specimen container into the stream of urine and collect as much urine as possible. Fill the container 3/4 full if possible.
8. Screw the cover securely onto the specimen container.
9. Label container with patientís name (first and last), date of birth or medical record number, date and time of collection, and collectorís initials.
10. Fill urine culture transport tube to the line (or more) with the specimen and label as stated above.
11. Maintain sterility and forward urine culture transport tube promptly to laboratory at ambient temperature. (Alternative: If urine culture transport tube is not available, send specimen refrigerated in original screw-capped specimen container.)

NOTE: SPECIMEN SOURCE IS REQUIRED ON REQUEST FORM FOR PROCESSING


INDWELLING CATHETER URINE

1. Do not submit urine from catheter bag.
2. If necessary, clamp the catheter tubing to collect urine in the tube, but do not allow the clamp to remain for more than 30 minutes.
3. Clean the sampling port (or tubing site if a port is not available) with alcohol swabs.
4. Insert a syringe with 21 gauge needle into the tubing port and withdraw urine into the syringe.
5. Transfer the urine into a urine culture transport tube (fill at least to line).
6. Label tube with patientís name (first and last), date of birth or medical record number, date and time of collection, and collectorís initials.
7. Maintain sterility and forward promptly to laboratory at ambient temperature. (Alternative: If urine culture transport tube is not available, send specimen refrigerated in a sterile, screw-capped specimen container labeled as stated above.)

NOTE: SPECIMEN SOURCE IS REQUIRED ON REQUEST FORM FOR PROCESSING.


STRAIGHT CATHETER or CYSTOSCOPY URINE

1. Avoid contamination of the specimen during collection.
2. If there is sufficient volume of specimen, fill urine culture transport tube to the line (or more) with the specimen and label container with patientís name (first and last), date of birth or medical record number, date and time of collection, and collectorís initials. (Alternative: If urine culture transport tube is not available or specimen volume is not sufficient to fill tube, place specimen in a sterile screw-capped specimen container properly labeled.)
3. Maintain sterility and forward urine culture transport tube promptly to laboratory at ambient temperature. (Alternative: Send unpreserved urine specimen refrigerated.)

NOTE: SPECIMEN SOURCE IS REQUIRED ON REQUEST FORM FOR PROCESSING 

Reference Values Not applicable 
Analytic Time 3 Days 
Day(s) Test Set Up Monday through Sunday 
CPT Code(s) 87077  Bacterial identification, if indicated
87086  Urine bacteria culture
87149 x5  CRE Confirmation, if indicated
87181  Antibiotic susceptibility (gradient strip), per antibiotic tested, if indicated
87184  Antibiotic susceptibility (disc method), if indicated
87186  Antibiotic susceptibility (MIC), if indicated