Overview
SOMB code 98.12Q is paid for the removal of atypical or neoplastic lesion(s) by any method, excluding cryotherapy for actinic keratosis. It applies when clinical suspicion warrants lesion removal and pathological assessment.
Billing Requirements
- Clinical suspicion of an atypical or neoplastic lesion
- Removal performed by any method (excluding cryotherapy for actinic keratosis)
- Pathology submission where clinically indicated
Common Audit Traps
⚠️ Alberta Health auditors specifically look for these mistakes when reviewing 98.12Q claims:
- Billing 98.12Q for cryotherapy treatment of actinic keratosis (explicitly excluded)
- Billing 98.12Q for purely cosmetic benign lesion removal
Clinical Example
Shave excision of a suspicious pigmented lesion sent to pathology. Bill 98.12Q.
Documentation Tips (Audit-Proof)
- Chart the clinical suspicion prompting removal
- Record the method used and pathology submission
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