All codes
L116
L116 – L116
OHIP Dermatology Code · Schedule of Benefits
When to Use
- Use L116 for the excision of a single benign lesion, such as a skin tag or small seborrheic keratosis, that does not require formal closure or complex tissue handling.
- Select L116 when performing a simple shave or snip excision of a lesion where the primary intent is removal rather than diagnostic biopsy (which would be billed under Z402).
- Apply L116 for minor dermatological procedures that fall outside the scope of a standard office visit (A007) but do not meet the complexity criteria for Z403 or Z404.
Common Pitfalls
- Billing L116 in addition to a minor assessment (A007) on the same day is often rejected unless the assessment is for a separate, unrelated clinical issue.
- Attempting to bill L116 multiple times for the same lesion is incorrect; use the appropriate multiple-lesion modifiers or higher-tier excision codes if the procedure complexity increases.
- Confusing L116 with diagnostic biopsy codes like Z402, which carries different requirements regarding the submission of pathology specimens.
Billing Tips
- Ensure the clinical note clearly describes the lesion size and the specific removal technique used to justify L116 over a standard consultation or assessment code.
- If removing multiple lesions, verify if the specific OHIP schedule allows for cumulative billing or if a different procedural code is required to avoid automatic rejection.
Provider Fee$20.68
Effective: July 1, 2010
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