Diagnosis: Hyperglycemia
Issue under review: Inpatient admission

Determination:
The inpatient admission was not medically necessary.

This patient presented with hyperglycemia and dehydration in the setting of nonadherence to his glucose lowering medications. The documentation does not support that he was hemodynamically unstable. He did not have acidosis or elevated ketones to support a diagnosis of diabetic ketoacidosis. He did not have altered mental status to support a diagnosis of hyperglycemic hyperosmolar syndrome. He was tachycardiac and had an elevated creatinine level consistent with dehydration. The documentation does not support that he had severe dehydration that failed management under observation status. Therefore, no, the proposed inpatient admission was not medically necessary.