All codes
L862
L862 – Surgical Pathology, Level 2
OHIP Dermatology Code — DIAGNOSTIC AND THERAPEUTIC PROCEDURES · Schedule of Benefits
When to Use
- Use L862 for the examination of simple specimens that require gross and microscopic examination but do not meet the criteria for L861, such as a skin tag or a simple cyst.
- Select L862 when the pathology report confirms a diagnosis that is straightforward and lacks the complexity or extensive tissue processing required for L863 or higher.
Common Pitfalls
- Billing L862 for specimens that actually qualify as L863 or higher based on the College of Physicians and Surgeons of Ontario (CPSO) complexity guidelines leads to significant under-billing.
- Submitting L862 alongside L822 or L823 for the same specimen is a common cause of rejection due to duplicate service claims for the same diagnostic procedure.
Billing Tips
- Always cross-reference the specimen description in your pathology report against the specific tissue lists in the Schedule of Benefits to ensure the complexity level aligns with L862 rather than L861.
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