I am not sure I am following you all, the 650 code does NOT include tears/lacerations. The 650 code states "delivery requiring minimal or no assistance, with or without episiotomy (which is not the same as a laceration or a tear, this is a "cut" done by the doctor)"...
the codes for a first degree tear/laceration is 664.0X; perineal laceration, rupture or tear involving fourchette, hymen, labia, skin, vagina, vulva
second degree tear/laceration is 664.1X; perineal laceration, rupture or tear (following episiotomy) involving pelvic floor, perineal muscles, vaginal muscles.
I hope this helps but if i am off track, pls let me know. Thanks!