Diagnosis: Hyperglycemia
Treatment: Inpatient admission
The inpatient admission was not medically necessary.
This patient presented with hyperglycemia and dehydration in the setting of missed insulin doses. He was awaiting coronary artery bypass grafting which was rescheduled to a later date. The documentation does not support that the patient was hemodynamically unstable. He did not have acidosis to support a diagnosis of diabetic ketoacidosis. He did not have altered mental status to support a diagnosis of hyperglycemic hyperosmolar syndrome. He had an elevated creatinine level consistent with dehydration. The documentation does not support that the patient had severe dehydration that failed management under observation status. The patient was transitioned to subcutaneous insulin and appropriately hydrated after an overnight stay and discharged the day after admission. Therefore, the proposed inpatient stay was not medically necessary.