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L553

L553L553

OHIP Dermatology Code · Schedule of Benefits

When to Use

  • Use L553 when billing for the excision of a skin lesion that is specifically categorized as a benign lesion, such as a seborrheic keratosis or skin tag.
  • Select L553 instead of the more complex excision codes like Z301 when the procedure involves a simple removal that does not require formal layered closure or complex reconstruction.

Common Pitfalls

  • Billing L553 in conjunction with a minor assessment code (A007) is often rejected unless the assessment is for a separate, unrelated clinical issue.
  • Submitting L553 for a malignant lesion is a common audit trigger; use the appropriate 'E' series codes for malignant excisions instead.
  • Attempting to bill L553 alongside a consultation code (A005) for the same lesion will result in a rejection for duplicate service.

Billing Tips

  • Ensure the pathology report supports the benign diagnosis if the claim is flagged, as the Ministry may request documentation to justify the use of L553 over a diagnostic biopsy code.
Provider Fee$5.22

Effective: April 1, 2018

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