All codes
L649
L649 – L649
OHIP Dermatology Code · Schedule of Benefits
When to Use
- Use L649 for the excision of a malignant lesion where the pathology report confirms a diagnosis that qualifies for the specific fee, distinguishing it from simple benign excisions like L645.
- Apply this code when the procedure involves a full-thickness excision of a malignant skin lesion requiring closure, provided the anatomical site and size criteria are met.
Common Pitfalls
- Billing L649 in conjunction with a minor procedure code like G538 is often rejected if the clinical note does not clearly delineate the separate nature of the two procedures.
- Submitting L649 for a lesion that is later determined to be benign by pathology will trigger a recovery audit; ensure the diagnosis code matches the malignant nature of the lesion.
Billing Tips
- Always append the appropriate diagnostic code for malignancy to avoid automatic rejection and ensure the claim reflects the complexity of the excision.
Provider Fee$67.21
Effective: July 1, 2010
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