Urinary Calculi (Stone Analysis)

NAME OF PROCEDURE

Urinary Calculi (Stone Analysis)

SYNONYMS

Bladder Stone; Calculi; Calculus Analysis; Genitourinary Stone Profile;  Kidney Stone Analysis; Renal Calculus Analysis; Ureteral Stone

CPT CODE(S)

82360

TEST INCLUDES

  • Qualitative analysis for the following:
  • Ammonium acid urate
  • Calcium bilirubinate
  • Calcium carbonate
  • Calcium hydrogen phosphate
  • Calcium oxalate dehydrate
  • Calcium oxalate monohydrate
  • Calcium phosphate
  • Cellular material
  • Cholesterol
  • Core composition
  • Cysteine
  • Dried blood
  • Magnesium ammonium phosphate
  • Newberyite
  • Sodium uric acid
  • Triamterene
  • Uric acid
  • Uric acid dihydrate

ADDITIONAL TEST INCLUDE

Color;  Size;  Weight

SPECIMEN

Calculi

COLLECTION

Clean dry container

COLLECTION TECHNIQUE

Calculi must be submitted completely dry.  Wash specimen free of tissue and blood.  Specimens should not be submitted in liquid (formalin, urine, blood, etc.), in gauze, filters, taped or on Q-tips.  A delay in analyzing and reporting specimens will ensue if not received completely dry.

REQUEST FORM

Complete a <Anatomical Pathology Requisition>.

The following information must be completed on each requisition.

  1. Patient’s Name
  2. Patient’s Date of Birth
  3. Social Security Number (if available)
  4. Date and time of collection
  5. Specimen source and tissue type
  6. Requesting Physician name and contact phone number
  7. Thorough clinical history if available
  8. All insurance information must be included to ensure proper billing.

CAUSE(S) FOR REJECTION

Specimen container not properly labeled

ADDITIONAL INFORMATION

Seventy percent of all renal stones are calcium oxalate or calcium phosphate.  Twenty percent are magnesium ammonia phosphate (struvite triple phosphate) and are associated with chronic urinary tract infection with urea splitting organisms such as Proteus.  The remainder contains uric acid, xanthine, cysteine, and silicates.

Twenty-four hour urine collections for creatinine clearance, uric acid, oxalate, calcium, urine culture, urine nitroprusside (for cystinuria), urine volume, and fasting morning urine pH (with electrolytes, for renal tubular acidosis) may be indicated.  Chemistry serum panel to include calcium (for hyperthyroidism), phosphorous, alkaline phosphatase (for Paget’s disease of bone), uric acid, BUN, and creatinine.  Serum soidium potassium chloride and CO2 and possibly parathormone (PTH) levels may be useful additional investigations.

Most calcium stones relate to idiopathic hypercalciuria and hyperuricosuria, which may coexist.  Uncommon causes of renal stone are sarcoid, Cushing’s syndrome, excessive calcium or vitamin D ingestion, steroids, immobilization, bone disease, Paget’s disease of bone and hyperthyroidism.  Hyperoxaluria may also be a factor to be evaluated.

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