All codes
L431
L431 – L431
OHIP Dermatology Code · Schedule of Benefits
When to Use
- Use L431 for the laboratory requisition of a complete blood count (CBC) when performed as a standalone service.
- Use this code when ordering a routine hemoglobin and hematocrit test for a patient during an office visit.
Common Pitfalls
- Do not bill L431 in addition to a comprehensive assessment code like A007, as the laboratory requisition is considered bundled into the visit fee.
- Avoid billing L431 if the laboratory test is performed within a hospital setting, as these are typically covered under global hospital budgets rather than physician fee-for-service.
Billing Tips
- Ensure the laboratory requisition is clearly linked to the diagnostic code that justifies the medical necessity of the blood work to prevent claim rejection.
Provider Fee$9.31
Effective: July 1, 2010
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