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L637

L637L637

OHIP Dermatology Code · Schedule of Benefits

When to Use

  • Use L637 for the excision of a malignant lesion on the trunk or extremities when the lesion diameter is less than 2 cm.
  • Select L637 when performing a simple excision of a skin lesion that does not require complex reconstruction or flap closure.
  • Use L637 instead of G005 or G006 when the procedure is specifically an excision of a malignant lesion rather than a diagnostic biopsy or benign removal.

Common Pitfalls

  • Billing L637 in conjunction with a minor assessment code (A007) on the same day is frequently rejected unless the assessment is for an unrelated condition.
  • Submitting L637 for benign lesions is a common audit trigger; ensure the pathology report confirms malignancy to support the code selection.
  • Failing to include the specific site of the lesion in the claim notes often leads to manual review or rejection by the Ministry.

Billing Tips

  • If the excision requires a complex closure, bill the appropriate repair code (e.g., Z301) in addition to L637, ensuring the total length of the repair is documented.
  • Always verify the lesion size against the Schedule of Benefits, as lesions 2 cm or larger require the use of higher-valued codes such as L638.
Provider Fee$25.85

Effective: July 1, 2010

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