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L525

L525L525

OHIP Dermatology Code · Schedule of Benefits

When to Use

  • Use L525 for the excision of a malignant lesion of the skin or subcutaneous tissue where the lesion size is between 2.1 cm and 3.0 cm in diameter.
  • Select L525 instead of L524 when the measured diameter of the lesion exceeds 2.0 cm but remains under 3.1 cm.

Common Pitfalls

  • Billing L525 for a benign lesion excision, which must instead be billed under the A-series minor surgery codes.
  • Failing to include the pathology report reference or the specific anatomical site in the claim, which frequently triggers manual review or rejection for lesion size verification.
  • Attempting to claim L525 in conjunction with a consultation or assessment code on the same day without a valid diagnostic code indicating a separate, unrelated clinical issue.

Billing Tips

  • Ensure the lesion diameter is measured and documented at the time of excision, as auditors prioritize the clinical measurement over the final pathology report size due to tissue shrinkage.
  • If performing a complex reconstruction or flap closure following the excision, bill the appropriate repair code in addition to L525, ensuring the excision is the primary procedure.
Provider Fee$103.40

Effective: July 1, 2010

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