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L048

L048L048

OHIP Dermatology Code · Schedule of Benefits

When to Use

  • Use L048 for the professional component of a diagnostic Pap smear when the physician performs the collection and interpretation of the slide.
  • Apply this code when submitting for a routine screening cytology specimen that does not meet the criteria for more complex diagnostic pathology codes.

Common Pitfalls

  • Billing L048 in conjunction with a physical examination code like A007 is often flagged as unbundling if the collection is considered part of the general assessment.
  • Submitting L048 when the specimen was sent to an external laboratory for processing will result in a rejection, as this code is intended for physician-performed interpretation.

Billing Tips

  • Ensure the clinical indication for the cytology is clearly linked to the diagnostic code to avoid automated rejections for lack of medical necessity.
Provider Fee$9.12

Effective: April 1, 2018

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