Medicare Benefits Schedule - Note PN.2.7

Urine microscopy and culture using item 69333 should only be undertaken for patients with symptoms of a urinary tract infection and/or kidney disease, or when clinically indicated as per the groups specified in the item descriptor.

Common symptoms of urinary tract infection or kidney disease may include but are not limited to:

• burning sensation during urination
• haematuria
• frequent or infrequent urination
• urine that is dark, cloudy, frothy or strong smelling
• pain or pressure in the lower abdomen and/or pelvic region
• nausea and/or vomiting
• chills and/or fever
• signs of sepsis or delirium

The following situations (without symptoms or risk factors listed in the description) do not make item 69333 applicable:

• undergoing non-urological surgery
• spinal cord injuries
• diabetes
• indwelling urinary catheters
• advanced age or aged care residency

Additionally, urine microscopy and culture should not be performed to check clearance of infection in the absence of continuing symptoms, except where a patient suffers from recurrent urinary tract infections.

Related Items: 69333

• Previous - Note PN.2.6
• Next - Note PN.2.8

Urine examination (including serial examinations), if:

(a) the patient has symptoms of urinary tract infection or kidney disease, or is a clinically‑indicated asymptomatic patient who is:

(i) pregnant; or

(ii) less than 16 years of age; or

(iii) a renal transplant recipient; or

(iv) suffering from recurrent urinary tract infections; or

(v) being investigated or monitored for kidney disease; or

(vi) undergoing urinary tract instrumentation, a urological procedure or transurethral resection of the prostate; and

(b) the examination is performed by any means other than simple culture by dip slide, including:

(i) cell count; and

(ii) culture; and

(iii) colony count; and

(iv) (if performed) stained preparations; and

(v) (if performed) identification of cultured pathogens; and

(vi) (if performed) antibiotic susceptibility testing; and

(vii) (if performed) examination for pH, specific gravity, blood, protein, urobilinogen, sugar, acetone or bile salts

Fee: $20.55 Benefit: 75% = $15.45 85% = $17.50

(See para PN.2.7 of explanatory notes to this Category)