All codes
T652
T652 – T652
OHIP Other Code · Schedule of Benefits
When to Use
- Use T652 for the excision of a malignant lesion of the skin or subcutaneous tissue when the lesion diameter is between 1.0 cm and 1.9 cm.
- Select T652 specifically for excisions on the trunk, extremities, or scalp, as these sites are generally categorized under this code range compared to facial excisions which may fall under different codes.
- Apply T652 when the procedure involves a full-thickness excision requiring primary closure, distinguishing it from simple biopsies or superficial destructions.
Common Pitfalls
- Billing T652 with a diagnostic code that does not support malignancy will trigger an automatic rejection or audit, as this code is specifically for malignant lesions.
- Submitting T652 alongside a minor procedure code like G538 is often rejected as the excision is considered to include the local anesthetic and basic closure.
- Failing to document the precise diameter of the lesion can lead to recovery of funds if an audit determines the lesion size was smaller than the 1.0 cm threshold required for this fee.
Billing Tips
- Always append the appropriate diagnostic code for the specific malignancy (e.g., ICD-9 173.x) to ensure the claim aligns with the clinical requirements of T652.
- If multiple lesions are excised during the same encounter, bill the primary lesion at 100% and subsequent lesions at 50% using the appropriate multiple procedure indicator.
Provider Fee$36.70
Specialist Fee$45.79
Effective: April 1, 2025
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