Effective October 7, 2026, the reflex-to-microscopy criteria for Urinalysis with Microscopy if Indicated (LAB1231026) will be updated. These changes are intended to reduce unnecessary microscopic examinations while ensuring clinically significant findings continue to receive appropriate follow-up testing.
Why are we making this change?
As part of ongoing laboratory stewardship efforts, Corewell Health Laboratories reviewed current urinalysis reflex practices and benchmarked our approach against peer healthcare organizations and industry best practices. Based on this review, the reflex criteria are being updated to better align microscopy utilization with clinical need while reducing unnecessary testing.
Updated reflex to microscopy criteria:
Microscopy will be performed on urine specimens if any of the following criteria are met:
• If the UA is positive for blood, protein, nitrite, or leukocyte esterase in patients ≥7 days old
• If the patient is neutropenic with an ANC of ≤1.5 x 109/L on the most recent CBC with Differential within 7 days
Current vs. Updated Reflex Criteria
| Test Finding |
Current Build |
Updated Build |
| Glucose |
✓ |
|
| Bilirubin |
✓ |
|
| Ketones |
✓ |
|
| Blood |
✓ |
✓ |
| Protein |
✓ |
✓ |
| Nitrite |
✓ |
✓ |
| Leukocyte Esterase |
✓ |
✓ |
| Clarity |
✓ |
|
| ANC ≤1.5 x 10⁹/L on recent CBC |
✓ |
Questions?
Please contact your local Laboratory Customer Service Department or Laboratory Account Manager:
- Southeast Michigan: 800.551.0488
- Southwest Michigan: 269.983.8311 ext 1
- West Michigan: 616.774.7721
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