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L630

L630L630

OHIP Dermatology Code · Schedule of Benefits

When to Use

  • Use L630 for the excision of a single benign lesion, such as a skin tag or small seborrheic keratosis, when the procedure is performed via simple excision.
  • Select L630 when the lesion is removed by simple excision rather than by curettage or cauterization, which would fall under different minor surgery codes.
  • Apply L630 for the removal of a single lesion where the clinical documentation confirms the lesion was benign and the excision was straightforward.

Common Pitfalls

  • Billing L630 in addition to an office visit (A007) for the same patient on the same day is often rejected unless the visit is for a separate, unrelated clinical issue.
  • Attempting to bill L630 multiple times for multiple lesions on the same day will trigger a rejection; use the appropriate multiple-lesion modifiers or secondary codes if applicable.
  • Confusing L630 with L631 or L632, which are reserved for more complex excisions or different anatomical considerations, leading to audit flags for incorrect code selection.

Billing Tips

  • Ensure the clinical note clearly describes the excision technique to justify L630 over other minor procedure codes that may have different fee structures.
  • If performing multiple excisions, verify the current Schedule of Benefits for the specific rules regarding the reduction of fees for subsequent lesions billed on the same day.
Provider Fee$17.37

Effective: April 1, 2018

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