Diagnosis: Dizziness.
Treatment: Inpatient admission.

The insurer denied the inpatient admission.
The denial is upheld.

The patient is a male with a history of hypertension, hyperlipidemia and diabetes. He presented with the compliant of dizziness/vertigo, worse with change in position.

At presentation, the patient's neurological examination was normal. CT (computed tomography) brain was normal. He was admitted for evaluation and treatment to the acute inpatient setting. His symptoms had resolved and he was discharged.

No, the Inpatient admission was not medically necessary.

The patient presented with dizziness/vertigo and had a normal neurological examination with end gaze nystagmus (normal finding), normal neuro-imaging and position dependent symptoms, which is inconsistent with TIA (transient ischemic attack)/stroke. There was nothing concerning from history of present illness or examination that would warrant acute inpatient admission. The clinical evaluation, diagnostic testing, monitoring and treatment could have been safely and effectively provided at a lower level of care.