top of page
< Back

201912-123762

2020

Healthfirst Inc.

Medicaid

Central Nervous System/ Neuromuscular Disorder

Inpatient Hospital

Medical necessity

Upheld

Case Summary

Diagnosis: Weakness, dizziness, blurred vision
Treatment: Inpatient admission

The Inpatient admission was not medically necessary.

The patient is a male with a history of stroke. He presented with the complaint of generalized weakness, dizziness and blurred vision. At presentation, he had a normal neurological examination and CT brain. He was evaluated by a neurologist, and no change to his treatment regimen was recommended.

The patient presented with nonspecific complaints and a normal neurological evaluation. There were no concerning features on history, diagnostic studies or examination to suggest an acute neurological event. The patient's complaints could have been safely and effectively evaluated, monitored and treated at lower level of care. Therefore, the Inpatient admission was not medically necessary.

bottom of page