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L495

L495L495

OHIP Dermatology Code · Schedule of Benefits

When to Use

  • Use L495 for the laboratory handling fee when you collect a specimen in your office and forward it to an external laboratory for analysis.
  • Apply this code when the specimen collection is the sole purpose of the patient encounter, as it cannot be billed in addition to an office visit fee like A007.

Common Pitfalls

  • Billing L495 alongside an office visit code (e.g., A007, A001) will result in an automatic rejection because the visit fee is considered inclusive of the collection service.
  • Attempting to bill L495 for specimens collected by hospital staff or external laboratory technicians is an audit risk, as the code requires the physician or their office staff to perform the collection.

Billing Tips

  • Ensure the laboratory requisition clearly indicates that the specimen was collected in your office to support the claim if audited.
Provider Fee$6.81

Effective: April 1, 2018

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