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L185

L185L185

OHIP Dermatology Code · Schedule of Benefits

When to Use

  • Use L185 for the laboratory requisition of a routine complete blood count (CBC) when performed as a standalone diagnostic investigation.
  • Apply this code when ordering a basic hematology panel for a patient presenting with non-specific fatigue or suspected anemia.
  • Select L185 when the diagnostic intent is strictly limited to the CBC, distinguishing it from more comprehensive panels that might require L047 or L050.

Common Pitfalls

  • Billing L185 in conjunction with a comprehensive metabolic panel or other complex lab codes can trigger a rejection if the Ministry deems the services redundant or bundled.
  • Submitting L185 for point-of-care testing performed in the office is a common audit error, as this code is intended for laboratory-processed specimens only.
  • Failure to link the specific diagnostic code (ICD-9) to the L185 requisition often leads to payment denials for lack of medical necessity.

Billing Tips

  • Ensure the L185 is billed only once per patient encounter, as multiple units for the same date of service are frequently flagged for manual review.
  • Verify that the laboratory requisition form matches the billing code exactly to avoid discrepancies during automated Ministry reconciliation.
Provider Fee$20.68

Effective: July 1, 2010

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