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UPJ INSIGHT: Critical Examination of Indications for Urinalysis in the United States
By: Kyle H. Gennaro, MD; Gerald McGwin Jr, MS, PhD; Peter N. Kolettis, MD | Posted on: 17 Jan 2023
Gennaro KH, McGwin G Jr, Kolettis PN. Critical examination of indications for urinalysis in the United States. Urol Pract. 2023;10(1):20-24.
Study Need and Importance
Urinalysis (UA) is commonly performed, and microhematuria is frequently detected. A small percentage of patients with microhematuria will have a serious underlying condition, so urological evaluation with CT urogram and cystoscopy is indicated.
What We Found
Table. International Classification of Diseases, 10th Edition Diagnoses Associated With Urinalysis
| ICD-10 Code | Diagnosis | Frequency, % |
|---|---|---|
| Z000 | Encounter for General Adult Examination | 15.8 |
| N390 | Urinary Tract Infection | 5.5 |
| I10 | Essential Hypertension | 3.7 |
| R300 | Dysuria | 2.2 |
| R109 | Unspecified Abdominal Pain | 1.9 |
| Z0001 | Encounter for General Adult Medical Examination With Abnormal Findings | 1.6 |
| E119 | Type 2 DM Without Complications | 1.6 |
| E785 | Hyperlipidemia, Unspecified | 1.3 |
| Z01818 | Encounter for Preprocedural Examination | 1.3 |
| R319 | Hematuria, Unspecified | 1 |
| Abbreviations: DM, diabetes mellitus; ICD-10, International Classification of Diseases, 10th edition. | ||
Our data show that UA is frequently performed without an appropriate indication (see Table).
Limitations
Our study has limitations. It is retrospective and limited by our data sources. It did not account for smoking status and did not examine “pseudohematuria,” ie, dipstick-positive UA only.
Interpretation for Patient Care
Routine UA screening is not supported by specialty guidelines, yet is commonly performed. Selective UA testing could help patients avoid invasive testing, lost time from work, and reduce health care costs.
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