CPT Codes

81015

Synonyms

  • Urinalysis Routine
  • Urine Sediment Examination

Test Includes

Examination of sediment, WBCs/µL, RBCs/µL, casts, crystals and other significant findings

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

Imaging microscopy

Use

Screen for renal disease, urinary tract infection

Limitations

May be difficult to interpret without a urine macroscopic examination. Urines with specific gravity <1.01 may yield falsely "low" results.

Additional Information

Epithelial cells: A few are not considered abnormal, mature females may have many squamous
Casts: Small number of hyaline/granular may be seen in normal urine
Crystals: Vary in urine with pH and concentration. Abnormal crystals include cystine, leucine, tyrosine, and cholesterol
Crystalluria is uncommon despite maximal concentrations in warm, fresh urine because of the normal presence of crystal inhibitors, the lack of available nidus, and the time factor. When properly observed in fresh urine, crystals are diagnostically useful for a physician evaluating microhematuria, nephrolithiasis, or toxin ingestion.
In abundance, calcium oxalate and/or hippurate crystals may suggest ethylene glycol ingestion (if accompanied by neurological abnormalities, appearance of drunkenness, hypertension, and a high anion gap acidosis).
Calcium magnesium ammonium phosphate may be present in massive quantities in alkaline urine. They usually are associated with urine infected by urea splitting bacteria which cause "infection" or "triple phosphate" stones.
Cystine crystals can be associated with cystinuria (failure of renal tubular reabsorption) and cystinosis (an inherited metabolic defect). In either disorder, calculi can be formed.
Tyrosine and leucine crystals are found in acid urine, indicating abnormal metabolism. These crystals occur together in acute yellow atrophy and in other destructive diseases of the liver.
Crystals may also provide a clue to the composition of renal stones not yet passed.
Leukocyturia may indicate inflammatory disease in the genitourinary tract, including bacterial infection, glomerulonephritis, chemical injury, autoimmune diseases, or inflammatory disease adjacent to the urinary tract such as appendicitis or diverticulitis.
White cell casts indicate the renal origin of leukocytes, and are most frequently found in acute pyelonephritis. White cell casts are also found in glomerulonephritis, such as lupus nephritis, and in acute interstitial nephritis.
Red cell casts indicate renal origin of hematuria and suggest glomerulonephritis, including lupus nephritis. Red cell casts may also be found in subacute bacterial endocarditis, renal infarct, vasculitis, Goodpasture's syndrome, sickling, and in malignant hypertension.
Dark brown or smoky urine suggests a renal source of hematuria.
Pink or red urine suggests an extrarenal source.
Hyaline casts occur in physiologic states (eg, after exercise) and many types of renal diseases.
Renal tubular (epithelial) casts are most suggestive of tubular injury, as in acute tubular necrosis. They are also found in other disorders, including eclampsia, heavy metal poisoning, ethylene glycol intoxication, and acute allograft rejection.
Granular casts are very finely granulated casts which may be found after exercise
Coarse granular casts are abnormal and are present in a wide variety of renal diseases.
Dark brown granular casts are typical of acute tubular necrosis.
Waxy casts are found especially in chronic renal diseases, and are associated with chronic renal failure
They occur in diabetic nephropathy, malignant hypertension, and glomerulonephritis.
Fatty casts are generally found in the nephrotic syndromes diabetic nephropathy, other forms of chronic renal diseases, and glomerulonephritis. The fat droplets originate in renal tubular cells when they exceed their capacity to reabsorb protein of glomerular origin.
Broad casts originate from dilated, chronically damaged tubules or the collecting ducts. Broad waxy casts are called renal failure casts.
Spermatozoa may be seen in male urine related to recent or retrograde ejaculation. In female urine, the presence of spermatozoa may provide evidence of vaginal contamination following recent intercourse.

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

6 mL

Stability

Inpatient: 6 hours
Outpatient:72 hours

Shipping and Handling Instructions

Transport specimen 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

Microscopy
RBCs 0-11/μL
RBCs/HPF 0-2/HPF
WBCs 0-22/μL
WBCs/HPF 0-4/HPF
Squamous epithelial cells 0-17/μL
WBC Clumps Absent
Bacteria Absent
Renal Epithelial Cells  None
Transitional Epithelial Cells 0-11 cells/uL
Hyaline Casts 0-2/LPF
Granular Casts Absent
Waxy Casts 0/LPF
Fatty Casts 0/LPF
RBC Casts 0/LPF
WBC Casts 0/LPF
Epithelial Casts 0/LPF
Mixed Casts 0/LPF
Crystal Absent
Calcium Oxalate Crystal Absent
Uric Acid Crystal Absent
Triple Phosphate Crystal Absent
Carbonate Crystal Absent
Calcium Phosphate Crystal Absent
Leucine Crystal Absent
Cystine Crystal Absent
Tyrosine Crystal Absent
Ammonium Biurate Absent
BIlirubin Crystal Absent
Cholesterol Crystal Absent
Hippuric Crystal Absent
Sulfa Crystal Absent
Fat Globules Absent
Oval Fat Bodies Absent
Yeast Absent
Motile Flagellate Absent
Test Information

CPT Codes

81015

Synonyms

  • Urinalysis Routine
  • Urine Sediment Examination

Test Includes

Examination of sediment, WBCs/µL, RBCs/µL, casts, crystals and other significant findings

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

Imaging microscopy

Use

Screen for renal disease, urinary tract infection

Limitations

May be difficult to interpret without a urine macroscopic examination. Urines with specific gravity <1.01 may yield falsely "low" results.

Additional Information

Epithelial cells: A few are not considered abnormal, mature females may have many squamous
Casts: Small number of hyaline/granular may be seen in normal urine
Crystals: Vary in urine with pH and concentration. Abnormal crystals include cystine, leucine, tyrosine, and cholesterol
Crystalluria is uncommon despite maximal concentrations in warm, fresh urine because of the normal presence of crystal inhibitors, the lack of available nidus, and the time factor. When properly observed in fresh urine, crystals are diagnostically useful for a physician evaluating microhematuria, nephrolithiasis, or toxin ingestion.
In abundance, calcium oxalate and/or hippurate crystals may suggest ethylene glycol ingestion (if accompanied by neurological abnormalities, appearance of drunkenness, hypertension, and a high anion gap acidosis).
Calcium magnesium ammonium phosphate may be present in massive quantities in alkaline urine. They usually are associated with urine infected by urea splitting bacteria which cause "infection" or "triple phosphate" stones.
Cystine crystals can be associated with cystinuria (failure of renal tubular reabsorption) and cystinosis (an inherited metabolic defect). In either disorder, calculi can be formed.
Tyrosine and leucine crystals are found in acid urine, indicating abnormal metabolism. These crystals occur together in acute yellow atrophy and in other destructive diseases of the liver.
Crystals may also provide a clue to the composition of renal stones not yet passed.
Leukocyturia may indicate inflammatory disease in the genitourinary tract, including bacterial infection, glomerulonephritis, chemical injury, autoimmune diseases, or inflammatory disease adjacent to the urinary tract such as appendicitis or diverticulitis.
White cell casts indicate the renal origin of leukocytes, and are most frequently found in acute pyelonephritis. White cell casts are also found in glomerulonephritis, such as lupus nephritis, and in acute interstitial nephritis.
Red cell casts indicate renal origin of hematuria and suggest glomerulonephritis, including lupus nephritis. Red cell casts may also be found in subacute bacterial endocarditis, renal infarct, vasculitis, Goodpasture's syndrome, sickling, and in malignant hypertension.
Dark brown or smoky urine suggests a renal source of hematuria.
Pink or red urine suggests an extrarenal source.
Hyaline casts occur in physiologic states (eg, after exercise) and many types of renal diseases.
Renal tubular (epithelial) casts are most suggestive of tubular injury, as in acute tubular necrosis. They are also found in other disorders, including eclampsia, heavy metal poisoning, ethylene glycol intoxication, and acute allograft rejection.
Granular casts are very finely granulated casts which may be found after exercise
Coarse granular casts are abnormal and are present in a wide variety of renal diseases.
Dark brown granular casts are typical of acute tubular necrosis.
Waxy casts are found especially in chronic renal diseases, and are associated with chronic renal failure
They occur in diabetic nephropathy, malignant hypertension, and glomerulonephritis.
Fatty casts are generally found in the nephrotic syndromes diabetic nephropathy, other forms of chronic renal diseases, and glomerulonephritis. The fat droplets originate in renal tubular cells when they exceed their capacity to reabsorb protein of glomerular origin.
Broad casts originate from dilated, chronically damaged tubules or the collecting ducts. Broad waxy casts are called renal failure casts.
Spermatozoa may be seen in male urine related to recent or retrograde ejaculation. In female urine, the presence of spermatozoa may provide evidence of vaginal contamination following recent intercourse.
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

6 mL

Stability

Inpatient: 6 hours
Outpatient:72 hours

Shipping and Handling Instructions

Transport specimen 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

Microscopy
RBCs 0-11/μL
RBCs/HPF 0-2/HPF
WBCs 0-22/μL
WBCs/HPF 0-4/HPF
Squamous epithelial cells 0-17/μL
WBC Clumps Absent
Bacteria Absent
Renal Epithelial Cells  None
Transitional Epithelial Cells 0-11 cells/uL
Hyaline Casts 0-2/LPF
Granular Casts Absent
Waxy Casts 0/LPF
Fatty Casts 0/LPF
RBC Casts 0/LPF
WBC Casts 0/LPF
Epithelial Casts 0/LPF
Mixed Casts 0/LPF
Crystal Absent
Calcium Oxalate Crystal Absent
Uric Acid Crystal Absent
Triple Phosphate Crystal Absent
Carbonate Crystal Absent
Calcium Phosphate Crystal Absent
Leucine Crystal Absent
Cystine Crystal Absent
Tyrosine Crystal Absent
Ammonium Biurate Absent
BIlirubin Crystal Absent
Cholesterol Crystal Absent
Hippuric Crystal Absent
Sulfa Crystal Absent
Fat Globules Absent
Oval Fat Bodies Absent
Yeast Absent
Motile Flagellate Absent

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