All codes
L054
L054 – L054
OHIP Dermatology Code · Schedule of Benefits
When to Use
- Use L054 for the collection of a specimen for a Pap smear when performed by a physician or nurse practitioner.
- Bill this code when the primary purpose of the visit is the cervical screening procedure, rather than a comprehensive physical exam (K030).
- Use L054 when a patient presents specifically for a Pap smear outside of a routine periodic health examination.
Common Pitfalls
- Do not bill L054 in addition to a general assessment code like A007 or A001, as the specimen collection is considered bundled into the assessment fee.
- Avoid billing L054 if the Pap smear is performed during a visit where a diagnostic code is used for an acute complaint, as the collection is included in the visit fee.
- Billing L054 for a pelvic exam that does not include a Pap smear collection will result in a rejection or clawback during an audit.
Billing Tips
- Bill L054 as a standalone service only when no other assessment or consultation code is claimed for the same encounter.
- Ensure the laboratory requisition clearly indicates the cytology screening to support the necessity of the L054 claim.
Provider Fee$17.06
Effective: July 1, 2010
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