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201904-116505

2019

United Healthcare Plan of New York

HMO

Central Nervous System/ Neuromuscular Disorder

Inpatient Hospital

Medical necessity

Upheld

Case Summary

This is a patient with past medical history of CVA, craniotomy, seizures, diabetes, chronic cholecystitis, and status post cholecystectomy who presented with weakness and decreased oral intake. The patient was treated with IV fluids and potassium. A neurology consult was done. The health plan's determination was upheld. While the patient needed further care, it could have safely and effectively been provided at a lower level.

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