Lacerations 98.22A and 98.22B

Billing lacerations can be tricky. Follow these steps to arrive at the appropriate number of calls.

Remember the 3 L’S: Length, Location and Layers.

Length and Location

For total lengths that are over any unit by any amount, round up to the next unit.

Layers

For multiple layered lacerations, measure and count each layer separately

Billing Steps

• Measure the total the length of all laceration(s).
• Convert the length into number of units using the above definitions.
• For facial lacerations up to 2.5cm or body up to 5cm, use 98.22A.
• Any lengths over those stated in 3 above, use 98.22B with the number of calls equal to the number of total units (regardless of location).

Examples

1. A patient has a small laceration, one layer on the cheek that is 2.3 cm.
   • Bill HSC 98.22A.
2. A patient has a double layer laceration on the cheek 2.5 cm long each layer.
   • Bill HSC 98.22B 2 calls.
3. A patient has two lacerations: a leg laceration with two layers (superficial layer 10 cm, deep layer 5 cm), and a 2.5 cm facial laceration.
   • Bill 98.22B 4 units – 3 units for the leg lacerations (layer one 2 units, layer two 1 unit); face laceration 1 unit.

NOTE: The following applies to HSCs 98.22A and 98.22B.

1. Benefit includes primary closure of wound by any method excluding adhesive tape skin closure or simple bandaging, normal wound care follow-up and suture removal.
2. Where the laceration is treated with the use of adhesive tape skin closure or simple bandaging, a visit should be claimed.
3. Where multiple lacerations are repaired, use the combined length.

Need more help?

• Access the Fee Navigator
• Access the Schedule of Medical Benefits
• Read the Allied Health practitioner’s resource guide
• Read the Physician's resource guide
• Register for billing seminars
• Contact us with any billing questions