Diagnosis: Back Pain and Numbness
Treatment: Inpatient admission
The insurer denied the inpatient admission
The denial is overturned

The patient is a male with neck and left scapular pain after a recent trauma. Exam reveals no weakness. Patient was started on IV (intravenous) decadron and opioids. MRI (magnetic resonance imaging) showed multilevel cervical stenosis.

Yes, the Inpatient admission was medically necessary.
The patient had severe radicular pain that required IV (intravenous) decadron and imaging studies and possible therapeutic intervention. This patient's symptoms and treatment required acute inpatient level of care. Therefore, this hospitalization was medically necessary and appropriate for this patient.

This hospitalization should be covered. The care that was provided could not be provided at a lower level of care. The patient required IV (intravenous) medications that could not be delivered at lower level of care. In addition, the patient had consultations and imaging studies that would require acute inpatient stay. Finally, there was a chance that he might require surgery. Therefore, it was appropriate to keep the patient at this level of care.