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L664

L664L664

OHIP Dermatology Code · Schedule of Benefits

When to Use

  • Use L664 for the excision of a malignant lesion on the trunk or extremities where the pathology report confirms malignancy and the lesion size is 2 cm or less.
  • Select L664 instead of minor procedure codes like G372 when the primary intent is the definitive surgical removal of a biopsy-proven malignant skin cancer.

Common Pitfalls

  • Billing L664 for benign lesions or simple cysts will trigger an audit; ensure the diagnosis code reflects a malignant neoplasm (e.g., ICD-9 173.x).
  • Submitting L664 alongside a consultation or assessment code (A007) for the same patient on the same day without a valid diagnostic code modifier or medical necessity documentation often leads to automatic rejection.

Billing Tips

  • If the excision requires a complex closure or reconstruction, bill the appropriate Z-code (e.g., Z300 series) in addition to L664, ensuring the surgical site is clearly identified.
Provider Fee$25.85

Effective: July 1, 2010

Since Oct 1989, this fee has increased 0.0% vs 13.1% CPI inflation

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