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T422

T422T422

OHIP Other Code · Schedule of Benefits

When to Use

  • Use T422 for the excision of a malignant lesion of the skin or mucous membrane where the diameter of the lesion is between 1.1 cm and 2.0 cm.
  • Select T422 when the procedure involves a simple excision that does not require complex reconstruction or flap closure, distinguishing it from more extensive procedures like T423.

Common Pitfalls

  • Billing T422 in conjunction with a minor assessment code (A007) is frequently rejected unless the assessment is for an unrelated condition or a separate clinical issue.
  • Submitting T422 for a lesion smaller than 1.1 cm is a common audit trigger; ensure the pathology report confirms the lesion size meets the threshold for this specific fee code.

Billing Tips

  • Always document the exact size of the lesion in the operative note, as the Ministry may request this data to justify the T422 fee over the lower-valued T421.
Provider Fee$93.70
Specialist Fee$93.70

Effective: April 1, 2025

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