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L216

L216L216

OHIP Dermatology Code · Schedule of Benefits

When to Use

  • Use L216 when performing a diagnostic or therapeutic aspiration of a joint or bursa that does not involve the injection of a therapeutic agent.
  • Use L216 for simple aspiration procedures where the primary intent is fluid removal for analysis or pressure relief, distinguishing it from the injection-inclusive code L217.

Common Pitfalls

  • Billing L216 in conjunction with a consultation or assessment code on the same day is often rejected unless a distinct, unrelated clinical issue is addressed and documented.
  • Attempting to bill L216 alongside L217 for the same joint site is a duplicate billing error, as the injection code L217 inherently covers the aspiration process.

Billing Tips

  • Ensure the procedure note explicitly states that only aspiration was performed to justify the use of L216 over the higher-valued L217 injection code.
Provider Fee$13.44

Effective: April 1, 2018

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