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201910-122559

2019

Healthfirst Inc.

Medicaid

Central Nervous System/ Neuromuscular Disorder

Inpatient Hospital

Medical necessity

Upheld

Case Summary

Diagnosis: Numbness and left sided weakness
Treatment: Inpatient admission

The inpatient admission was not medically necessary.

The patient is a female. She presented with the complaint of left-sided numbness and weakness. At presentation, her vital signs were stable and computed tomography (CT) of the brain was negative.

The patient had six hours of paresthesia and normal neuro-imaging. Her presentation was not consistent with stroke or TIA (transient ischemic attack). The patient could have safely and effectively completed the diagnostic studies, monitoring and treatment at a lower level of care.

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