CPT Code: Serum Urea Nitrogen, Urine Urea Nitrogen in mg/dl, 24 hour Urine Urea Nitrogen, Urea Clearance

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1 UREA CLEARANCE UREACL Specimen Required: 2.5 ml blood, gel tube and total collection 24 hour urine Special Instructions: Refrigerate urine during collection. Provide starting date and time, and ending date and time Reference Range: ml/min CPT Code: Test Includes: Serum Urea Nitrogen, Urine Urea Nitrogen in mg/dl, 24 hour Urine Urea Nitrogen, Urea Clearance UREA NITROGEN - URINE 24 HOUR UREA24 Specimen Required: Total collection, 24 hour urine. Special Instructions: Refrigerate, provide starting date and time, and completion date and time. Reference Range: gm/24 hr CPT Code: UREA NITROGEN - URINE RANDOM UREAU Specimen Required: 10 ml urine Reference Range: Normals not established for random specimens CPT Code: URIC ACID URIC Specimen Required: Reference Range: 2.5 ml blood (0.6 ml minimum), gold gel or green tube or 1 full microtainer. Female: mg/dl Male: mg/dl 4 hours Daily Analytical Time: Day(s) Test Set Up: CPT Code: URIC ACID - URINE 24 HOUR URIC24 Specimen Required: Total collection, 24 hour urine. Special Instructions: Refrigerate, provide starting date and time, and completion date and time. Reference Range: mg/24 hr CPT Code: Page 1 2/19/2013

2 URIC ACID, URINE RANDOM URICR Specimen Required: 10 ml urine Reference Range: Normals not established for random specimens CPT Code: URINALYSIS UA Specimen Required: 10 ml urine (3 ml minimum) Special Instructions: Refrigerate Reference Range: See chart below CPT Code: Test Includes: Color, appearance, specific gravity, ph, protein, glucose, ketone, bilirubin, blood, nitrite, urobilinogen, microscopic Color: Yellow Character: Clear Glucose: Negative Specific Gravity: Ketone: Negative ph: Reducing substance: Negative Leukocyte: Negative Urobilinogen: Nitrate: Negative Bilirubin: Negative Protein: Negative Blood: Negative URINE CULTURE UC; CULUR Collection Guidelines: Clean Catch (CC) Female 1. Thoroughly clean urethral area with soap and water. 3. While holding labia apart, begin voiding. 4. After several ml. have passed, collect midstream portion without stopping flow of urine. Clean Catch (CC) Male 1. Clean the glans with soap and water. 3. While holding foreskin retracted, begin voiding. 4. After several ml. have passed, collect midstream portion without stopping flow of urine. Urine Catheter (CATH) 1. Thoroughly clean urethral area with soap and water. 3. Aseptically insert catheter into bladder. 4. Allow about 15 mls. to pass, then collect urine for submission. Catheter, Indwelling 1. Disinfect catheter collection port with 70% alcohol. Page 2 2/19/2013

3 2. Use needle and syringe to aseptically collect 5-10 mls of urine. Storage/Volume: Sterile Urine Collector (<=24 hours refrigerated) or Vacutainer Brand Urine Collection Kit(<= 48 hours, Room Temperature). Comments: Cath procedure not recommended for routine urine culture collection because of potential contamination problems. Procedure may introduce urethral flora into bladder. Do not submit catheter bag urine or stagnant urine in urine line. Collection within 24 hours of a catheter change gives best results. Analytical Time: 2-5 days CPT Code: 87086; additional tests may be ordered as needed _ URINE DIPSTICK Specimen Required: 20 ml urine Special Instructions: Refrigerate Analytical Time: 2 hours CPT Code: Test Includes: Color, appearance, specific gravity, ph, protein, glucose, ketone, bilirubin, blood, nitrite, urobilinogen VALPROIC ACID VAL Specimen Required: 2.5 ml blood (0.6 ml minimum), gold gel or green tube or 1 full microtainer. Special Instructions: Valley: Immediately before next dose. Reference Range: ug/l CPT Code: VANCOMYCIN, PEAK VANP Specimen Required: 2.5 ml blood (0.6 ml minimum), gold or green gel tube or 1 full microtainer. Special Instructions: Draw 1 2 hours after 1.5 hours of infusion or 1 hour after a 2 hour infusion. Reference Range: ug/ml VANCOMYCIN, RANDOM Page 3 2/19/2013

4 VANR Specimen Required: 2.5 ml blood (0.6 ml minimum), gold or green gel tube or 1 full microtainer Reference Range: 5 40 µg/ml VANCOMYCIN, VALLEY VANV Specimen Required: 2.5 ml blood (0.6 ml minimum), gold or green gel tube or 1 full microtainer Special Instructions: Draw just prior to next dose Reference Range: ug/ml VARICELLA ZOSTER VIRUS ANTIBODY(IGG) VAR; CHICKEN POX; HERPES ZOSTER G; VZIGG; VZVIGG Specimen Required: 2.5 ml blood,gel tube Reference Range: </=0.90 EIA Analytical Time: 3-5 days Day(s) Test Set Up: Tuesday-Saturday CPT Code: VDRL CSF VDRLCSF Specimen Required: 1 ml CSF Reference Range: Non Reactive Analytical Time: 3-5 days Day(s) Test Set Up: Monday, Wednesday and Friday CPT Code: VITAMIN A VITA Specimen Required: 2.5 ml blood, gel tube Special Instructions: Protect from light Reference Range: ug/dl (1-6 years ug/dl (7-12 years) ug/dl (13-19 years ug/dl (Adults) Day(s) Test Set Up: Monday-Friday CPT Code: VITAMIN B-12 B12 Page 4 2/19/2013

5 Specimen Required: 3 ml blood, gel tube Special Instructions: Avoid hemolysis Reference Range: pg/ml CPT Code: VITAMIN D-25 HYDROXY VITD25; HYDROXY; VIT D 250H Specimen Required: 2.5 ml blood, gel tube Reference Range: ng/ml Day(s) Test Set Up: Tuesday-Saturday CPT Code: VMA - URINE 24 HOUR VMA; HAVUR Specimen Required: Total collection, 24 hour urine Special Instructions: Acidify with 25 ml 6N HCl. Patient should avoid high doses of triamterene, octopamine, fruit juices and phenylpyruvic acid Day(s) Test Set Up: Monday - Saturday CPT Code: Page 5 2/19/2013

Purpose Provide instructions for collection of optimal urine specimens to ensure accurate test results.

Purpose Provide instructions for collection of optimal urine specimens to ensure accurate test results. Policy S:PC-2110 Page 1 Fairview Health Services Department Laboratory / Nursing Section Acute Care: Collection Category Provision of Care Subject URINE COLLECTION, RANDOM/CATHETER/OTHER Purpose Provide