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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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