Clinical pathway for child head injury management

Released 22/02/2019

A clinical pathway has been developed and tested in conjunction with the Northern Regional Alliance, Auckland Health Pathways, ACC, and clinical representatives from primary and urgent care. This helps clinicians to identify and manage head injuries in children who don't need hospital admission. 

As part of the pathway, clinicians may need to undertake a Child Sport Concussion Assessment Tool (SCAT5).

Due to the extended nature of this assessment, the following ACC funding may be available: 

Billing code Description Price (GST incl.)
GPSC GP SCAT5 Assessment for Mild TBI in children/youth $127.22

Criteria for billing

  • A SCAT5 assessment must have been completed by an appropriate clinician following the clinical pathway described
  • The code may be billed for assessments that happened on or after 1 December 2018
  • The code is only available for assessment of concussion in children under 16
  • The price is a set fee and can only be billed once per claim
  • The price has been set at a rate to encourage practices to provide zero fees in this instance, however, it is up to individual practices to set their co-payment levels
  • The code cannot be billed in conjunction with any other consultation or procedure code
  • The code is not able to be billed by DHBs for acute presentations. 

We’ll monitor the use of the code and it may change. If this happens, we’ll share more information about its availability and criteria.

Use your local health pathway.


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