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L168

L168L168

OHIP Dermatology Code · Schedule of Benefits

When to Use

  • Use L168 for the professional component of a diagnostic Pap smear when the specimen is collected and submitted for cytological examination.
  • Apply this code when billing for the interpretation of a cervical or vaginal smear in conjunction with a patient encounter where the primary purpose is screening or diagnostic investigation.

Common Pitfalls

  • Do not bill L168 in addition to a comprehensive physical examination fee if the Pap smear is considered a routine part of the examination under the Schedule of Benefits.
  • Avoid billing L168 if the laboratory processing fee is already being claimed by the facility, as this code is strictly for the professional interpretation component.

Billing Tips

  • Ensure the diagnostic code linked to L168 reflects the specific clinical indication, such as abnormal bleeding or follow-up of a previous abnormal result, to justify the professional fee.
Provider Fee$10.89

Effective: April 1, 2018

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