Does Medicare Cover Urinalysis?

Medicare Benefits Solutions
Apr 23, 2021

There are many reasons why your doctor may ask you for a urine sample and order a urinalysis. The content, appearance and concentration of your urine can be used to check your overall physical health, which is why providing a sample is standard procedure for a routine physical exam. A urinalysis may also be done to monitor a previously diagnosed medical condition and determine if the treatment plan is working or needs modification.

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Labwork Considerations

Additionally, lab work may be performed in response to certain symptoms that you report to your doctor. Examples are blood in your urine, pain in your abdomen or back, or pain or increased frequency when you urinate.

These issues prompt healthcare practitioners to search for disorders like urinary tract infection (UTI), diabetes, kidney disease or kidney stones. Test results can help to rule out or flag an underlying condition. Additional tests may be required to confirm a diagnosis.

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Clinical Diagnostic Laboratory Tests

Urinalysis is one of the laboratory services covered under Part B. Medicare benefits also include blood tests, screening tests and some tissue specimen testing. To be covered, the test must be medically necessary, ordered by a qualified health care practitioner and performed by a Medicare-approved laboratory. If the test is approved, you should not expect any out-of-pocket expense for lab services.

Some urine tests, such as those performed to detect pregnancy or drug use, are done to look for specific substances. When testing for pregnancy, the lab will look for a hormone known as human chorionic gonadotropin (HCG). Drug screenings, like those that may be required by an employer, are used to detect certain types of drugs. A urinalysis for non-medical purposes would not be covered.

How a Urinalysis is Done

Follow your health care provider’s pre-test instructions. Most likely, there will be no food or beverage restrictions unless other tests will be performed simultaneously. If you take prescription drugs or over-the-counter products like vitamin supplements, be sure your doctor is aware to ensure an accurate evaluation.

Because the most concentrated urine is in the morning, your doctor may prefer you collect your sample as soon as you wake up. You may be asked to deliver the sample directly to the lab. This should be done within an hour. If that is not possible, you may refrigerate it.

A lab technician’s three-prong approach when processing a urine sample includes a visual exam to determine color and clarity. A dipstick test involves the application of chemicals that change the sample’s color in the presence of certain substances. Studying the sample under a microscope is effective in capturing the quantity of white blood cells, red blood cells, bacteria or yeasts, proteins and crystals.

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