All codes
L370
L370 – L370
OHIP Dermatology Code · Schedule of Benefits
When to Use
- Use L370 for the initial diagnostic assessment of a patient with a suspected or confirmed malignancy when a formal consultation is required.
- Apply this code when evaluating a patient referred for a second opinion regarding the staging or management of a known cancer diagnosis.
- Select L370 instead of A007 when the complexity of the oncological assessment meets the criteria for a specialist consultation rather than a standard office visit.
Common Pitfalls
- Billing L370 in conjunction with a minor procedure code on the same day often triggers an automatic rejection or audit if the consultation is not clearly distinct.
- Submitting L370 for routine follow-up visits instead of the appropriate assessment code (e.g., A007) will result in payment recovery during post-payment audits.
- Failing to include a valid referring physician number on the claim will cause an immediate rejection of the L370 fee.
Billing Tips
- Ensure the consultation note explicitly documents the referral source and the specific clinical question asked to justify the L370 fee over a standard assessment.
- If the patient requires a subsequent visit for the same condition, switch to the appropriate follow-up code (e.g., A007) to avoid billing violations.
Provider Fee$28.44
Effective: July 1, 2010
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