CPT Codes

81002 (Nonautomated)
81003 (Automated)

Synonyms

  • Urinalysis, Macroscopic

Test Includes

Color, specific gravity, pH, protein, glucose, ketones, bilirubin, occult blood, nitrite, leukocyte esterase.

Performing Laboratory / Facility

Ronald Reagan UCLA Medical Center Clinical Laboratory
Santa Monica UCLA Medical Center and Orthopaedic Hospital
UCLA Outreach Clinical Laboratory - Panorama City (BURL)

Performing Section

Urinalysis

Availability

Ronald Reagan UCLA Medical Center Clinical Laboratory and Santa Monica UCLA Medical Center and Orthopaedic Hospital: Daily, 24 hours (including holidays)
Outreach Clinical Laboratory - Panorama City (BURL): Monday-Friday 0600-0230, Saturday 1200-2030 (excluding holidays)

Turnaround Time

Ronald Reagan UCLA Medical Center Clinical Laboratory and Santa Monica UCLA Medical Center and Orthopaedic Hospital: Routine 4 hours from receipt in the Laboratory; STAT 1 hour from receipt in the Laboratory
Outreach Clinical Laboratory - Panorama City (BURL): Routine 24 hours; Stat: 4 hours from receipt in the laboratory

Methodology

Atago and/or Arkray for specific gravity and dipstick

Use

Screen for abnormalities of urine
Diagnose and manage renal diseases, urinary tract infection, urinary tract neoplasms, systemic diseases, and inflammatory or neoplastic diseases adjacent to the urinary tract

Limitations

Insufficient volume, <3 mL, may limit the extent of procedures performed. Metabolite of Pyridium® may interfere with the dipstick reactions by producing color interference. High vitamin C intake may cause an underestimate of glucosuria, or a false-negative nitrate test. Specific gravity is affected by glucosuria, mannitol infusion or prior administration of iodinated contrast material for radiologic studies (IVP dye). False-positive tests for protein can also be due to contamination of the urine by an ammonium containing cleansing solution. Bence Jones proteins may not be detected by dipstick method.

Additional Information

COLOR
Colorless urine may be normal or secondary to diuretic use, high fluid intake, diabetes insipidus, or diabetes mellitus. Cloudy or hazy urine may reflect the presence of phosphates, pyuria, or bacteriuria. On oxidation, development of a black color is evidence for alkaptonuria. Increased indican may cause the urine to blacken on standing. Dark urine is the second most common sign of acute intermittent porphyria. Very rarely, dark urine may indicate the presence of malignant melanoma. Green urine may be produced by indigo carmine, methylene blue, phenol, and in some cases of iodochlorhydroxyquin (clioquinol)-induced subacute myelo-opticoneuropathy. Other causes of green urine are reported as Pseudomonas bacteremia, urinary bile pigments amitriptyline hydrochloride or methocarbamol ingestion, and breath freshener abuse. Red plasma and red urine indicate hemoglobin
clear plasma with red urine may indicate myoglobin, but may occur as well in congenital erythropoietic porphyria and cutanea tarda porphyria. Purple urine, after standing, may also be due to porphyrins. Yellow to orange urine may contain bile. Other causes of darker yellow to orange urine include increased concentration of urine or the presence of riboflavin, quinacrine (Atabrine®), rifampin (Rifadin®, Rimactane®), phenazopyridine (Pyridium®), or salicylazosulfapyridine (Azulfidine®). The plastic urine bag may discolor purple in the presence of the indican produced by Providencia or Klebsiella species.
SPECIFIC GRAVITY Indicates the relative proportions of dissolved solid components to the total volume of the specimen. It reflects the relative degree of concentration or dilution of the specimen.
DIPSTICK
Blood in the urine is used to detect myoglobin, hemoglobin, or RBCs in the urine. Hematuria and hemoglobinuria may represent a variety of conditions.
Glucose in the urine usually indicates significant hyperglycemia. A positive screening test for urine glucose is a significant sign and indicates a substantial likelihood of diabetes mellitus.
pH is a crude measure of the acid-base balance of the body. It may be helpful in determining subtle presence of distal renal tubular disease or pyelonephritis. Urine pH is useful for identifying crystals in urine and determining predisposition to form a given type of stone.
Protein in the urine is a screen for nephrotic syndromes, including complications of diabetes mellitus, glomerulonephritis, amyloidosis, and other diseases. Proteinuria is probably the single most important indicator of renal disease.
Ketone in the urine is used to detect acetoacetic acid. Ketonuria can occur in infants and children with febrile illnesses or toxic states with marked vomiting or diarrhea. It may be noted in normal pregnancy, starvation, high protein diet, eclampsia thyrotoxicosis, and isopropanol ingestion.
Bilirubin in the urine is used to detect the presence of conjugated bilirubin. It can be a sign of liver disease or intra- or extrahepatic biliary obstruction.
Leukocyte esterase is used to detect the presence of white blood cells in the urine. The presence of WBCs can be an indication of inflammation.
Nitrite in the urine is used to detect for the presence of gram negative bacteria.
Reducing substances test is not performed unless requested.

Specimen Type

Random urine

Container

Urine Container, Clean Catch
Sterile Urine Container
BD Vacutainer UA Preservative Tube

Collection Instructions

Freshly voided random urine

Volume

15 mL

Minimum Volume

3 mL

Stability

Inpatient: 6 hours
Outpatient:72 hours

Shipping and Handling Instructions

Transport to the Laboratory as soon as possible after collection. Refrigerate specimen if it cannot be processed within 2 hours.

Causes for Rejection

Excessive delay in transport
Fecal contamination
Insufficient volume
Exceeds stability

Reference Range

Chemistry
Color Straw-Yellow
Appearance Clear
Specific gravity 1.005-1.030
pH 5.0-8.0
Protein Negative
Bilirubin Negative
Glucose Negative
Ketones Negative
Blood Negative
Nitrite Negative
Leukocyte esterase Negative
Test Information

CPT Codes

81002 (Nonautomated)
81003 (Automated)

Synonyms

  • Urinalysis, Macroscopic

Test Includes

Color, specific gravity, pH, protein, glucose, ketones, bilirubin, occult blood, nitrite, leukocyte esterase.

Performing Laboratory / Facility

Ronald Reagan UCLA Medical Center Clinical Laboratory
Santa Monica UCLA Medical Center and Orthopaedic Hospital
UCLA Outreach Clinical Laboratory - Panorama City (BURL)

Performing Section

Urinalysis

Availability

Ronald Reagan UCLA Medical Center Clinical Laboratory and Santa Monica UCLA Medical Center and Orthopaedic Hospital: Daily, 24 hours (including holidays)
Outreach Clinical Laboratory - Panorama City (BURL): Monday-Friday 0600-0230, Saturday 1200-2030 (excluding holidays)

Turnaround Time

Ronald Reagan UCLA Medical Center Clinical Laboratory and Santa Monica UCLA Medical Center and Orthopaedic Hospital: Routine 4 hours from receipt in the Laboratory; STAT 1 hour from receipt in the Laboratory
Outreach Clinical Laboratory - Panorama City (BURL): Routine 24 hours; Stat: 4 hours from receipt in the laboratory

Methodology

Atago and/or Arkray for specific gravity and dipstick

Use

Screen for abnormalities of urine
Diagnose and manage renal diseases, urinary tract infection, urinary tract neoplasms, systemic diseases, and inflammatory or neoplastic diseases adjacent to the urinary tract

Limitations

Insufficient volume, <3 mL, may limit the extent of procedures performed. Metabolite of Pyridium® may interfere with the dipstick reactions by producing color interference. High vitamin C intake may cause an underestimate of glucosuria, or a false-negative nitrate test. Specific gravity is affected by glucosuria, mannitol infusion or prior administration of iodinated contrast material for radiologic studies (IVP dye). False-positive tests for protein can also be due to contamination of the urine by an ammonium containing cleansing solution. Bence Jones proteins may not be detected by dipstick method.

Additional Information

COLOR
Colorless urine may be normal or secondary to diuretic use, high fluid intake, diabetes insipidus, or diabetes mellitus. Cloudy or hazy urine may reflect the presence of phosphates, pyuria, or bacteriuria. On oxidation, development of a black color is evidence for alkaptonuria. Increased indican may cause the urine to blacken on standing. Dark urine is the second most common sign of acute intermittent porphyria. Very rarely, dark urine may indicate the presence of malignant melanoma. Green urine may be produced by indigo carmine, methylene blue, phenol, and in some cases of iodochlorhydroxyquin (clioquinol)-induced subacute myelo-opticoneuropathy. Other causes of green urine are reported as Pseudomonas bacteremia, urinary bile pigments amitriptyline hydrochloride or methocarbamol ingestion, and breath freshener abuse. Red plasma and red urine indicate hemoglobin
clear plasma with red urine may indicate myoglobin, but may occur as well in congenital erythropoietic porphyria and cutanea tarda porphyria. Purple urine, after standing, may also be due to porphyrins. Yellow to orange urine may contain bile. Other causes of darker yellow to orange urine include increased concentration of urine or the presence of riboflavin, quinacrine (Atabrine®), rifampin (Rifadin®, Rimactane®), phenazopyridine (Pyridium®), or salicylazosulfapyridine (Azulfidine®). The plastic urine bag may discolor purple in the presence of the indican produced by Providencia or Klebsiella species.
SPECIFIC GRAVITY Indicates the relative proportions of dissolved solid components to the total volume of the specimen. It reflects the relative degree of concentration or dilution of the specimen.
DIPSTICK
Blood in the urine is used to detect myoglobin, hemoglobin, or RBCs in the urine. Hematuria and hemoglobinuria may represent a variety of conditions.
Glucose in the urine usually indicates significant hyperglycemia. A positive screening test for urine glucose is a significant sign and indicates a substantial likelihood of diabetes mellitus.
pH is a crude measure of the acid-base balance of the body. It may be helpful in determining subtle presence of distal renal tubular disease or pyelonephritis. Urine pH is useful for identifying crystals in urine and determining predisposition to form a given type of stone.
Protein in the urine is a screen for nephrotic syndromes, including complications of diabetes mellitus, glomerulonephritis, amyloidosis, and other diseases. Proteinuria is probably the single most important indicator of renal disease.
Ketone in the urine is used to detect acetoacetic acid. Ketonuria can occur in infants and children with febrile illnesses or toxic states with marked vomiting or diarrhea. It may be noted in normal pregnancy, starvation, high protein diet, eclampsia thyrotoxicosis, and isopropanol ingestion.
Bilirubin in the urine is used to detect the presence of conjugated bilirubin. It can be a sign of liver disease or intra- or extrahepatic biliary obstruction.
Leukocyte esterase is used to detect the presence of white blood cells in the urine. The presence of WBCs can be an indication of inflammation.
Nitrite in the urine is used to detect for the presence of gram negative bacteria.
Reducing substances test is not performed unless requested.
Specimen Collection and Handling

Specimen Type

Random urine

Container

Urine Container, Clean Catch
Sterile Urine Container
BD Vacutainer UA Preservative Tube

Collection Instructions

Freshly voided random urine

Volume

15 mL

Minimum Volume

3 mL

Stability

Inpatient: 6 hours
Outpatient:72 hours

Shipping and Handling Instructions

Transport to the Laboratory as soon as possible after collection. Refrigerate specimen if it cannot be processed within 2 hours.

Causes for Rejection

Excessive delay in transport
Fecal contamination
Insufficient volume
Exceeds stability
Result Interpretation

Reference Range

Chemistry
Color Straw-Yellow
Appearance Clear
Specific gravity 1.005-1.030
pH 5.0-8.0
Protein Negative
Bilirubin Negative
Glucose Negative
Ketones Negative
Blood Negative
Nitrite Negative
Leukocyte esterase Negative

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