Urinalysis (without microscopy)

What it is

A plastic strip carrying a row of reagent pads is dipped into the urine, and each pad changes color in proportion to what it detects. Between them the pads cover acidity, concentration, protein, glucose, ketones, bilirubin, blood and markers associated with infection. The appearance of the sample, clear or cloudy, pale or dark, is noted too. What this version does not include is any examination of the sediment under a microscope, so nothing is counted and nothing is identified by sight. It answers whether a substance is present, not what particles are in the urine or where they came from.

Why it is done

• To screen quickly during a checkup, before surgery, on hospital admission or in pregnancy, where the purpose is to catch an abnormality worth pursuing
• To check for sugar or protein spilling into the urine in someone with diabetes or kidney disease
• To make an immediate decision about symptoms of a urinary infection while the patient is still in the room
• To monitor a known condition at intervals, where the trend on the strip is enough and the sediment detail is not being asked for

What to expect

The sample is collected in a cup, often as a clean catch. The strip is read within a minute or two, either by eye against a color chart or by a small bench reader, so the result is usually available during the visit. Colors shift if the sample sits, which is why laboratories work from fresh urine. An abnormal strip generally leads onward: to a microscopic examination, to a culture, or to blood work, depending on which pad was abnormal.

Questions worth asking

• Was this done in the office during a visit, and if so, is it itemized on top of the visit charge or included in it?
• If the strip was abnormal and a microscopic exam or culture followed, how many separate lab charges ended up on the claim for one urine sample?
• Was this drawn as part of a pre-surgical or admission routine, and is that bundled into the procedure price or billed on its own?
• Is the price quoted for the strip test the same at the clinic, the hospital outpatient lab and a freestanding lab?