Uric Acid, 24 Hour Urine
| PATIENT INFO |
| Patient Name: |
| Medical Record #: |
| BD: / / Sex: F M |
| PHYSICIAN INFO |
| Physician Name : |
| Address: |
| Ph: ( ) - Fax: ( ) - |
| Additional Report to: |
| Ph: ( ) - Fax: ( ) - |
| TESTS REQUESTED | |
| Test Name: | ICD9 Code: (required) |
| 1. Uric Acid, 24 Hour Urine | |
| 2. | |
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| SPECIMEN INFO |
| Collection Date & Time: |
| Collected By: |
| Hospital: |
Test ID :
UAC24
Test Workstation :
CLEVE
Specimen Type:
Urine
Tube Type:
Urine container
Collection Volume:
24 hour urine collection
Storage:
Refrigerated
Availability:
Sent to reference lab
Methodology:
Uricase
Special Instructions:
5.0 mL (minimum 1.0 mL) aliquot from a 24 hour urine collection in a container without preservative. Instruct patient on 24 hour urine collection. To begin the urine collection, have the patient void. DISCARD THIS URINE SPECIMEN. This is best done with the first morning specimen. Note the time and record on the requisition. From then on collect all the urine that is voided and place in container. If more than one container is needed, please mark the first as #1 of 2 and retain on the floor until the collection is complete. The final void should be made 24 hours after the first void described earlier. The specimen should be included with the collection.
Lab/Phone:
330-543-8418
TAT:
24 hours
Additional Info:
Reference range: 250-750 mg/24 hours
CPT Code:
84560
