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L228
L228 – L228
OHIP Dermatology Code · Schedule of Benefits
When to Use
- Use L228 for the professional component of a diagnostic Pap smear screening when the physician performs the collection and interpretation of the specimen.
- Apply this code when submitting a claim for a cervical cytology screening that does not meet the criteria for a comprehensive physical examination under A007 or A001.
Common Pitfalls
- Billing L228 in conjunction with a full physical examination code like A007 is considered unbundling and will result in a rejection or recovery.
- Submitting L228 for a diagnostic test performed by a laboratory technician rather than the physician is a common cause for audit clawbacks.
Billing Tips
- Ensure the claim includes the appropriate diagnostic code for the indication of the Pap smear to avoid rejection for lack of medical necessity.
Provider Fee$10.86
Effective: July 1, 2010
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