All codes
L204
L204 – L204
OHIP Dermatology Code · Schedule of Benefits
When to Use
- Use L204 when billing for the laboratory requisition of a routine urinalysis (dipstick or microscopic) performed in the office setting.
- Apply this code specifically when the laboratory test is performed as a standalone service or as part of an office visit where the lab fee is not bundled into a global fee.
Common Pitfalls
- Billing L204 in conjunction with an office visit code (e.g., A007) is often rejected or considered inclusive unless the lab work is the primary reason for the encounter.
- Failing to include the appropriate diagnostic code that justifies the medical necessity of the urinalysis will lead to automatic claim rejection.
Billing Tips
- Ensure that the laboratory test is actually performed and documented in the patient chart, as L204 is a technical fee for the performance of the test, not just the requisition.
Provider Fee$1.16
Effective: April 1, 2018
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