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L261

L261L261

OHIP Dermatology Code · Schedule of Benefits

When to Use

  • Use L261 for the excision of a single benign lesion, such as a skin tag or small fibroma, that does not require complex closure or pathology.
  • Select L261 when performing a simple excision of a lesion on the trunk or extremities where the size does not qualify for the higher-valued excision codes like L262 or L263.

Common Pitfalls

  • Billing L261 in addition to a minor assessment code (A007) for the same lesion is considered double-dipping and will result in a rejection.
  • Submitting L261 for a lesion that requires a layered closure or extensive undermining may lead to an audit, as these procedures should be billed under more specific surgical codes.

Billing Tips

  • If multiple lesions are excised during the same encounter, apply the appropriate multiple procedure rules (usually 100% for the first, 85% for the second, and 75% for the third) to maximize your claim.
Provider Fee$24.98

Effective: April 1, 2018

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