Medicare patient had a 12 cm laceration on the left hand. She went to see her PCP and was referred for treatment. The doctor decided on treatment in an ASC because "the laceration was over 6 hours old and because of external laceration and resection of the skin". This was originally coded as 882.0 which does not support medical necessity for 11043. ICD-9 describes complications in the fourth-digit subdivision as including delayed treatment.

What I want to know is what constitutes delayed treatment in this type of injury. Help would be appreciated.