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L097

L097L097

OHIP Dermatology Code · Schedule of Benefits

When to Use

  • Use L097 for the collection of a specimen for a routine throat swab or nasal swab when performed in the office.
  • Apply this code when collecting a specimen for a routine culture and sensitivity that does not fall under the specific requirements of more complex laboratory procedure codes.

Common Pitfalls

  • Do not bill L097 in conjunction with an office visit fee (A007) as the specimen collection is considered bundled into the assessment fee.
  • Avoid billing L097 if the laboratory service is performed by a nurse or technician in a facility where the physician is not directly providing the service, as this is often considered a facility-based cost.

Billing Tips

  • Ensure the diagnostic code linked to L097 justifies the necessity of the specimen collection to avoid automated rejections during claims processing.
Provider Fee$3.10

Effective: July 1, 2010

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