All codes
L455
L455 – L455
OHIP Dermatology Code · Schedule of Benefits
When to Use
- Use L455 for the excision of a malignant lesion where the pathology report confirms malignancy, distinguishing it from benign lesion removals coded under Z001 or Z002.
- Apply this code when performing a surgical excision of a skin malignancy that requires a formal closure, as opposed to simple destruction techniques like cryotherapy or curettage which fall under different fee schedules.
Common Pitfalls
- Billing L455 alongside an office visit code (A007) on the same day is often rejected unless the visit is for an unrelated problem, as the fee for L455 is intended to include the pre-operative assessment.
- Failing to include the specific site and size of the lesion in the claim submission can lead to manual review or rejection, as the Ministry requires this data to validate the complexity of the excision.
Billing Tips
- If the excision requires a complex reconstruction or flap closure, ensure you are billing the appropriate surgical tray or additional procedural codes rather than relying solely on L455.
Provider Fee$38.78
Effective: July 1, 2010
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