L816 – Electron microscopy by TEM, STEM or SEM technique
OHIP Dermatology Code — DIAGNOSTIC AND THERAPEUTIC PROCEDURES · Schedule of Benefits
Electron microscopy by TEM, STEM or SEM technique. This service provides for the highly detailed examination of tissue or other biological samples using advanced microscopy. For cases requiring additional analysis, see L831 for analytical electron microscopy.
When to Use
- Use L816 for standard diagnostic ultrastructural examination of tissue samples, such as renal biopsies for suspected glomerulonephritis or muscle biopsies for metabolic myopathies.
- Select L816 when the clinical diagnostic pathway requires high-resolution imaging that exceeds the capabilities of standard light microscopy but does not necessitate the specialized analytical techniques covered under L831.
Common Pitfalls
- Billing L816 in conjunction with L831 for the same specimen is a common audit trigger; ensure the clinical necessity for both distinct procedures is clearly delineated in the pathology report.
- Submitting L816 without a formal referral from an eligible provider (Physician, NP, or Oral Maxillofacial Surgeon) will result in automatic rejection.
Billing Tips
- Ensure the pathology report explicitly mentions the use of TEM, STEM, or SEM to support the L816 claim, as the Ministry may request this documentation during a post-payment audit.
Effective: April 1, 2026
J. Diagnostic and Therapeutic Procedures
DIAGNOSTIC AND THERAPEUTIC PROCEDURES
Diagnostic
Diagnostic and Therapeutic Procedures
All insured services must be documented in appropriate records that establish the service was provided, the service claimed is the service that was rendered, and the service was medically necessary. See for details.
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