All codes
L524
L524 – L524
OHIP Dermatology Code · Schedule of Benefits
When to Use
- Use L524 for the professional fee associated with the excision of a malignant lesion where the pathology report confirms the diagnosis and the procedure meets the criteria for a major excision.
- Apply this code when the lesion size and anatomical location necessitate a complex excision that falls outside the scope of minor surgical procedures like Z001 or Z002.
- Bill L524 when performing a definitive excision of a confirmed basal cell or squamous cell carcinoma that requires a formal surgical closure.
Common Pitfalls
- Billing L524 in conjunction with minor surgical codes like Z001 or Z002 for the same lesion will trigger an automatic rejection for unbundling.
- Failure to document the specific size of the lesion and the pathology-confirmed diagnosis in the medical record is a primary cause for audit recovery.
- Attempting to bill L524 for a benign lesion excision is a billing error; benign lesions must be billed under the appropriate Z-code series based on the procedure performed.
Billing Tips
- Ensure the pathology report is finalized and linked to the patient chart before submitting the claim to avoid discrepancies during post-payment audits.
- If a reconstruction or complex flap is required following the excision, verify if an additional fee code for the reconstruction is eligible for payment alongside L524.
Provider Fee$103.40
Effective: July 1, 2010
Since Oct 1989, this fee has increased 0.0% vs 13.1% CPI inflation
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