Diagnosis: Asthma.
Treatment: Inpatient admission.

Insurer denied the inpatient admission. The denial is overturned.

Yes, the Inpatient admission was medically necessary.

The patient is a male. He presented with shortness of breath and wheezing. He was found to have asthma exacerbation. The patient was treated with IV steroids, duonebs, and supplemental oxygen. The patient also was seen by pulmonary consult for treatment resistant asthma exacerbation, cardiology consult for abnormal EKG (electrocardiogram).

The patient had failed home treatment for asthma. In the emergency room the patient was tachypneic and hypoxic with ambulation. Despite receiving multiple nebulizations, the patient continued to have respiratory distress and wheezing. The patient was started on IV steroids for asthma exacerbation.

The patient had continued wheezing and shortness of breath. Additionally, the patient had abnormal EKG and required cardiology consult and work up. Pulmonary consultation was also obtained, and recommendation was made for prolonged IV steroids.

The patient failed outpatient therapy, as well as emergency room therapy, and he had moderate to severe asthma exacerbation with new onset tachypnea, hypoxia with treatment-resistant exacerbation. He required prolonged IV steroids, as well as cardiac arrhythmias requiring inpatient cardiac work up. Therefore, the acute in-hospital stay was medically necessary.