Diagnosis: Hip pain Treatment: Inpatient admission, medication, monitoring The insurer denied the inpatient admission. The denial was upheld. Patient was brought in by ambulance to the Emergency Department (ED) with severe left hip pain and could not walk. Past medical history was significant for spinal stenosis and chronic hip pain. She was admitted to the hospital and provided with a Lidocaine patch and Flexeril. Imaging did not demonstrate a fracture. She was evaluated by physical therapy (PT) who recommended rehabilitation. She was discharged and provided with Celebrex. The hospital record demonstrated improvement after prescription pain medication was provided. The physical examination reported full range of motion to the left hip, but with pain. Consultations did not recommend additional testing, invasive management or parenteral medications. Her vital signs were stable. She was able to tolerate oral medications. She did not require treatment for underlying co-morbidities. All services could have been provided in the ED or in an outpatient setting. There were no extenuating circumstances to warrant the level of service provided (admission).

1) MCG 23rd Edition for Acute Hospitalization/Musculoskeletal