All codes
L169
L169 – L169
OHIP Dermatology Code · Schedule of Benefits
When to Use
- Use L169 for the professional component of a diagnostic Pap smear or cervical cytology screening when the specimen is collected and submitted for laboratory analysis.
- Apply this code when billing for the interpretation and reporting of a cervical cytology specimen in a clinical setting where the physician is responsible for the diagnostic outcome.
Common Pitfalls
- Billing L169 in conjunction with a general office visit fee code (e.g., A007) is often rejected unless the visit is for a separate, unrelated clinical issue with distinct documentation.
- Submitting L169 without the corresponding laboratory requisition number or failing to ensure the lab has billed the technical component separately will lead to claim discrepancies.
Billing Tips
- Ensure the diagnostic code used with L169 reflects the specific reason for the screening, such as an abnormal finding or routine surveillance, to avoid audit triggers.
Provider Fee$32.81
Effective: April 1, 2018
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