Diagnosis: Early Delivery/Labor (preterm labor)
Treatment: Inpatient admission
The insurer denied the inpatient admission.
The denial is upheld.

The patient is a female presenting with uterine spotting and contractions at 30 3/7 weeks of gestation. She was afebrile and all of her other vital signs were stable, she also had a non-focal or normal exam. She was not in labor and did not have any changes in her cervix. The fetal tracing was appropriate, and labs were normal. She was admitted for intravenous (IV) hydration and monitoring.

No, the proposed inpatient admission was not medically necessary.

The admission was not medically necessary since the patient had stable vital signs, she was afebrile, with a non-focal exam, normal labs, normal fetal tracing and was not in labor, and since her contractions did not result in changes in cervical dilation. This admission was not medically necessary since it is not standard of care, it is not supported by peer reviewed literature and it is not supported by professional organizations, given that the patient did not have any acute conditions necessitating inpatient level of care.