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L529

L529L529

OHIP Dermatology Code · Schedule of Benefits

When to Use

  • Use L529 for the excision of a malignant lesion of the skin or subcutaneous tissue when the lesion diameter is between 2.1 cm and 3.0 cm.
  • Select L529 instead of L528 when the measured diameter of the lesion exceeds 2.0 cm but remains under the 3.1 cm threshold for L530.
  • Apply this code for malignant lesion excisions on the trunk or extremities where the complexity does not warrant the use of a more specific reconstructive code like Z001.

Common Pitfalls

  • Billing L529 alongside a minor procedure code like G538 is often rejected; ensure the excision is the primary service provided during the encounter.
  • Failure to document the exact diameter of the lesion in the chart will lead to recovery during an audit, as the fee is strictly tiered based on size.
  • Do not bill L529 for benign lesions; these must be billed under the L000 series (e.g., L003) to avoid automatic claim rejection.

Billing Tips

  • Always measure the lesion diameter prior to excision and record the measurement in cm to justify the L529 code over the lower-valued L528.
  • If a biopsy was performed at a previous visit, ensure the L529 claim reflects the excision date only to prevent duplicate service flags.
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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