Urine Cytology

CPT: 88112
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Test Details

Synonyms

  • Urine, Bladder Washings/Lavage

Use

Establish the presence of primary or metastatic neoplasms; aid in the diagnosis of infections with herpesvirus, cytomegalovirus, Blastomyces, and Schistosoma; evaluate malacoplakia; establish the presence of cytomegalic inclusion disease

Limitations

Low-grade papillary transitional cell or urothelial carcinomas may not be diagnosed by cytologic examination. Calculi or recent instrumentation may produce atypical changes in urothelial cells simulating malignancy. Chemotherapy and radiation may also produce changes stimulating neoplasia. Viral culture is the method of choice for the diagnosis of CMV but cytology can provide faster results.

Methodology

The fluid will be centrifuged, supernatant poured off, and diagnostic cells aspirated from the remaining material. Filters, monolayers, and/or cytospins will be made along with a cell block, if applicable. Microscopic examination is performed.

Specimen Requirements

Specimen

Second morning specimen; voided or catheterized urine; intraoperative washings of urinary bladder, urethra, ureters, or renal pelvis

Volume

Not less than 50 mL

Container

Sterile plastic urine container

Patient Preparation

Hydrate patient (give several glasses of water 30 minutes to one hour prior to collection).

Collection

Have patient drink one glass (6 oz) every 15 minutes for two to three hours. At the end of two hours, have the patient void or catheterize. Discard specimen.

Technique I (routine): One hour after collection of discarded specimen, have patient void and save the specimen. Send labeled specimen to the laboratory immediately.

Technique II (when residual bladder urine is present): Thirty minutes to one hour after collection of discarded specimen, catheterize bladder. Send labeled specimen to the laboratory immediately.

Technique III (for detection of upper urinary tract lesions): Catheterize ureters to pelvis for suspected renal or pelvic lesions. Repeat procedure using either ureter for control. For ureteral lesion, catheterize ureter to a point just below the level of the suspected lesion. Catheterize other ureter for control. Collect urine for 30 minutes. Label appropriately, right and left ureteral or pelvic specimen. Ship specimen immediately to the laboratory.

Storage Instructions

If collected after hours, add equal amount of 50% ethyl alcohol or Saccomanno fixative and place in the laboratory refrigerator. (Note: Specimens prepared with fixatives that contain 50% ethyl alcohol, eg, Saccomanno fixative, are not acceptable for microbiology testing.) Specify source of specimen.

Causes for Rejection

Improper labeling; improper fixation; 24-hour collection; undue delay in transport; specimen submitted in vial that expired according to manufacturer's label; frozen specimen

Clinical Information

Special Instructions

Include patient's name, date of birth, sex, Social Security number, previous malignancy, drug therapy, radiation therapy, and all other pertinent clinical information, including history of alcohol abuse, on the request form. A first morning voided specimen is not suitable. Collection method must be identified. For CMV Study, indicate chemotherapy or immunosuppression.

LOINC® Map

Order Code Order Code Name Order Loinc Result Code Result Code Name UofM Result LOINC
009068 Urine Cytology 191115 Specimen type: 22633-2
009068 Urine Cytology 191152 Source: 22633-2
009068 Urine Cytology 191160 Clinician provided ICD9: 52797-8
009068 Urine Cytology 191174 Clinician provided ICD10: 52797-8
009068 Urine Cytology 191158 ****************************** N/A
009068 Urine Cytology 191118 DIAGNOSIS: 22637-3
009068 Urine Cytology 191165 Recommendation: 22638-1
009068 Urine Cytology 191140 Comment: 22638-1
009068 Urine Cytology 191159 ****************************** N/A
009068 Urine Cytology 191157 Pathologist provided ICD9: 52797-8
009068 Urine Cytology 191175 Pathologist provided ICD10: 52797-8
009068 Urine Cytology 191117 Clinical history: 22636-5
009068 Urine Cytology 191126 Amended report: N/A
009068 Urine Cytology 191127 Addendum: 22639-9
009068 Urine Cytology 191147 Diagnosis provided by: N/A
009068 Urine Cytology 191119 Signed out by: 19139-5
009068 Urine Cytology 191120 Performed by: N/A
009068 Urine Cytology 191116 Gross description: 22634-0
009068 Urine Cytology 191156 Microscopic description: 22635-7
009068 Urine Cytology 191141 Special procedure: N/A
009068 Urine Cytology 191179 Previous history: N/A
009068 Urine Cytology 191144 QA comment: N/A
009068 Urine Cytology 019018 . 11546-9
009068 Urine Cytology 000000 NonGyn CPT Code Automation N/A
009068 Urine Cytology 191167 Photomicrograph N/A

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CPT Statement/Profile Statement

The LOINC® codes are copyright © 1994-2017, Regenstrief Institute, Inc. and the Logical Observation Identifiers Names and Codes (LOINC) Committee. Permission is granted in perpetuity, without payment of license fees or royalties, to use, copy, or distribute the LOINC® codes for any commercial or non-commercial purpose, subject to the terms under the license agreement found at https://loinc.org/license/. Additional information regarding LOINC® codes can be found at LOINC.org, including the LOINC Manual, which can be downloaded at LOINC.org/downloads/files/LOINCManual.pdf