CPT® Code 81020

Official Description

Urinalysis; 2 or 3 glass test

Common Language Description

The CPT® Code 81020 refers to a urinalysis procedure known as the 2 or 3 glass test. This diagnostic test is specifically designed to assist healthcare professionals in identifying the location and cause of inflammation within the urethra, particularly in male patients. The procedure involves the collection of first morning urine, which is divided into two or three separate containers or glasses. Each glass is subsequently analyzed for the presence of white blood cells (WBCs) and red blood cells (RBCs). The turbidity, or cloudiness, of the urine specimens serves as a key indicator during this analysis. For instance, if the first glass shows turbidity while the subsequent glasses remain clear, it suggests that inflammation is localized to the anterior segment of the urethra, indicating a condition known as anterior urethritis. Conversely, if all collected samples exhibit turbidity, this points to the presence of both anterior and posterior urethritis. Additionally, the presence of blood in the samples provides further diagnostic insight; if only the first glass contains blood, it indicates anterior urethral inflammation, while blood in all samples suggests inflammation affecting both segments of the urethra. This structured approach to urinalysis is crucial for accurate diagnosis and subsequent management of urethral conditions.

1. Indications

The 2 or 3 glass test, represented by CPT® Code 81020, is indicated for the evaluation of urethral inflammation. This test is particularly useful in the following scenarios:

Urethritis Diagnosis This test is performed to help diagnose the site and cause of inflammation of the urethra, especially in male patients.
Assessment of Symptoms It is indicated for patients presenting with symptoms such as dysuria (painful urination), urethral discharge, or hematuria (blood in urine).
Localization of Inflammation The test helps in determining whether the inflammation is confined to the anterior urethra or if it extends to the posterior urethra.

2. Procedure

The procedure for the 2 or 3 glass test involves several key steps that ensure accurate collection and analysis of urine samples:

Step 1: Patient Preparation The patient is instructed to collect the first morning urine, which is typically more concentrated and provides better diagnostic information. Proper hygiene measures should be taken to minimize contamination.
Step 2: Collection of Urine Samples The patient collects urine in two or three separate glasses. The first glass is filled with the initial stream of urine, while the subsequent glasses are filled with the remaining urine. This separation is crucial for analyzing the presence of WBCs and RBCs in different segments of the urine.
Step 3: Laboratory Analysis Each glass is then analyzed in the laboratory for turbidity, which indicates the presence of WBCs, and for the presence of RBCs. The results from each glass are compared to determine the location of any inflammation.

3. Post-Procedure

After the completion of the 2 or 3 glass test, the patient may be advised to await the laboratory results, which will provide insights into the presence of urethritis. Depending on the findings, further diagnostic or therapeutic measures may be recommended. If inflammation is detected, the healthcare provider may discuss treatment options, which could include antibiotics or other interventions based on the underlying cause. Patients are typically monitored for any persistent symptoms and may require follow-up testing to assess the effectiveness of treatment.

Short Descr	URINALYSIS GLASS TEST
Medium Descr	URINALYSIS 2/3 GLASS TEST
Long Descr	Urinalysis; 2 or 3 glass test
Status Code	Statutory Exclusion (from MPFS, may be paid under other methodologies)
Global Days	XXX - Global Concept Does Not Apply
PC/TC Indicator (26, TC)	9 - Not Applicable
Multiple Procedures (51)	9 - Concept does not apply.
Bilateral Surgery (50)	9 - Concept does not apply.
Physician Supervisions	09 - Concept does not apply.
Assistant Surgeon (80, 82)	9 - Concept does not apply.
Co-Surgeons (62)	9 - Concept does not apply.
Team Surgery (66)	9 - Concept does not apply.
Diagnostic Imaging Family	99 - Concept Does Not Apply
CLIA Waived (QW)	No
APC Status Indicator	Conditionally packaged laboratory tests
Type of Service (TOS)	5 - Diagnostic Laboratory
Berenson-Eggers TOS (BETOS)	T1C - Lab tests - urinalysis
MUE	1
CCS Clinical Classification	206 - Microscopic examination (bacterial smear, culture, toxicology)