Diagnosis: Shortness of breath (Breathing Problem)
Treatment: Inpatient hospital

This is the case of a female with a past medical history of asthma who presented to the emergency department with chief complaint of shortness of breath, productive cough, and sore throat. She was admitted to the hospital.

The health plan's determination is overturned. The inpatient stay was medically necessary. This is a patient with asthma who presented with acute respiratory distress, accessory muscle use, wheezing, and a peak expiratory flow rate of 120 noted in the emergency department. Though she was not hypoxic, her work of breathing in addition to low peak expiratory flow of 120L was indicative of severe disease with high risk for treatment failure, potential impending respiratory failure and need for emergent aggressive treatment with IV steroids, NEBS, and frequent monitoring.