Test Code UAPR 
Methodology Chemstrip 9® or 10® / Refractometry / Microscopic Examination, if applicable 
Description Includes "Urine Screen, Random Urine". If leukocytes or protein are present in clinically significant amounts or if nitrite or occult blood are positive, or if appearance is not normal, the Urine Screen will be replaced by a "Urinalysis, With Sediment" at an additional charge. In addition, if leukocytes are present in clinically significant amounts or if nitrites are positive, or if sediment shows > 10-20 WBC/hpf or >= 2+ bacteria/hpf, a "Culture, Bacteria, Urine" will automatically be performed at an additional charge. Significant isolates reflex to organism identification and antibiotic susceptibility testing at an additional charge.

NOTE: In some infected patients, microorganisms and WBCs are present in low concentrations and will not be detected by this test. When this occurs, the test will not reflex to culture.

NOTE: Additional testing, Reducing Substances Random Urine, will be performed for patients with a negative glucose who are 2 yrs of age or under 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 10 mL (3.0 mL minimum) from a random, clean catch first-morning urine collection in a sterile, plastic urine container. Send specimen refrigerated.

NOTE: Urine received in the BD Vacutainer® Plus Plastic Conical UA Preservative tube, 16x100mm, 8mL (yellow & red Tiger top tube) is acceptable and stable refrigerated for up to 48 hours for testing for non-timed orders.

The BD Vacutainer® Urine C&S Preservative Plus Plastic Tube available in 13x75mm, 4mL draw (gray top culture & sensitivity tube) is not acceptable for urinalysis. 

Reference Values Specific gravity: 1.010 - 1.030
Leukocyte Esterase: Negative
Nitrite: Negative
pH: 5.0 - 8.0
Protein: Negative
Glucose: Normal
Ketones: Negative
Urobilinogen: Normal
Occult blood: Negative 
Analytic Time 1 Day - additional time if reflexed to culture 
Day(s) Test Set Up Monday through Sunday 
CPT Code(s) 81000  Non-auto with microscopic, if indicated - OR
81001  Auto with microscopic, if indicated - OR
81002  Non-auto without microscopic - OR
81003  Auto without microscopic
87077  Bacterial identification, if indicated
87086  Culture, if indicated
87186  Minimum inhibitory concentration, if indicated