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L626
L626 – L626
OHIP Dermatology Code · Schedule of Benefits
When to Use
- Use L626 for the collection and preparation of a cervical or vaginal smear for cytology when performed as a standalone procedure.
- Bill L626 when a Pap test is performed during an office visit where the primary purpose of the visit is not a periodic health examination or a specific diagnostic assessment that would otherwise include the smear in a global fee.
Common Pitfalls
- Do not bill L626 in addition to a periodic health examination code (e.g., K013) or a general assessment code (e.g., A007), as the smear collection is considered bundled into those comprehensive services.
- Avoid billing L626 alongside a minor procedure code if the smear collection is incidental to the primary procedure being performed.
Billing Tips
- Ensure the laboratory requisition is clearly linked to the service date to support the claim if audited for the performance of the collection.
- If you perform a pelvic exam and collect the smear during a visit billed with an A-code, ensure the medical necessity for the separate assessment is documented to justify the claim.
Provider Fee$10.16
Effective: April 1, 2018
Since Oct 1989, this fee has decreased 1.7% vs 29.0% CPI inflation
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