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Billing code

Z188A — Complex Laceration Repair, Anatomical Area Other Than Face, (except Digit, Zone 1 Repair)

Complex laceration repair, not face

Bill for a non-facial laceration repair taking at least 20 minutes with three or more layers or multiple ligated bleeders.

Watch for: Chart the repair time; if it doesn't meet the complex criteria, bill the simple laceration codes by length.

Code

Z188A

Description

Complex Laceration Repair, Anatomical Area Other Than Face, (except Digit, Zone 1 Repair)

FHO+ basket

Not in the FHO+ base rate basket (Schedule 2 or 2B).

Effective date

Apr 1, 2026

Termination date

No end date

Explanation

Updated October 26, 2026

Complex laceration repair anywhere except the face or a zone 1 digit injury: at least 20 minutes plus layered closure or ligation of multiple bleeders.

What it covers

A complex laceration repair of an area other than the face needs at least 20 minutes to perform the repair and at least one of: closure of three or more layers (such as muscle sheath, subcutaneous tissue and skin), or ligation of multiple bleeding vessels (M15).

It includes removal of any foreign bodies in the wound, irrigation and debridement (M16). Face repairs are Z187 and zone 1 digit repairs are Z189.

Billing rules

• Chart the repair time; only time spent on the repair itself counts, not other separately billable services (M16).
• Wound and ulcer debridement, Z128, Z129 and Z114 are not payable in addition for the same repair (M16).
• Plastic surgery codes R150 to R154 are not payable for any laceration repair (M16).
• If the repair doesn't meet the complex criteria, bill the simple laceration codes by length (Z176 to Z192) (M16).
• Surgical procedure: age premiums apply for patients under 16, from +10% (age 5–15) up to +30% (under 30 days) (GP64).
• Non-elective and done after hours: ED physicians billing H-codes add E412 (+20%, evenings/weekends/holidays) or E413 (+40%, 00:00–07:00); other physicians add E409 or E410 (GP104).
• E420 trauma premium (+50%) applies for qualifying trauma patients when the ISS is charted (GP109).

Often billed with

• E412 or E413 when an ED physician does it non-electively after hours (GP104).
• E420 trauma premium for qualifying trauma patients (GP109).

Related codes: Z187, Z189, Z176, Z175, Z179, Z191, Z114, Z128

Source: Schedule of Benefits (July 1, 2026), Integumentary System Surgical Procedures, Skin and Subcutaneous Tissue, page M15; rules M16.

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