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L728

L728L728

OHIP Dermatology Code · Schedule of Benefits

When to Use

  • Use L728 for the excision of a single benign skin lesion, such as a simple sebaceous cyst or lipoma, that does not require complex closure or flap reconstruction.
  • Select this code when the procedure is performed in an office setting for a lesion that is not considered a malignant or premalignant growth requiring the higher-valued Z-codes.

Common Pitfalls

  • Billing L728 in conjunction with a minor assessment code (A007) is generally disallowed unless the assessment is for a separate, unrelated clinical issue.
  • Submitting L728 for the removal of multiple lesions on the same day often triggers a rejection or requires the use of the appropriate multiple procedure logic (50% rule) for subsequent lesions.

Billing Tips

  • Ensure the pathology report is available to support the benign diagnosis if the claim is audited, as L728 is strictly for non-malignant tissue removal.
Provider Fee$20.68

Effective: July 1, 2010

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