SOLVED1328

Read the following patient scenario before answering the . PATIENT: Rita Spoke Medical Record #: XGK167 Date of Service: 04/16/xx CLINICIAN NOTE CHIEF COMPLAINT: Walk-in patient seen due to what she called a “food reaction”. After eating crab for the first time, she immediately experienced an influx of mucus, a dry hacking cough, and a rash on her body. She did not have trouble breathing, so she decided to come to urgent care instead of seeking treatment at the ER. FINDINGS: Apart from patient concerns, a review of remaining body systems was normal, she had no presence of wheezing, her lungs sounded clear, and she had no fever. Order was made for allergy testing. A month later, the patient received an Explanation of Benefits (EOB) from her health insurance company partially denying the claim as not medically necessary. She noticed additional charges of an IV and a chest x-ray on the EOB, neither of which she received. Explain why the insurance denied the charges for the IV and chest x-ray as not being medically necessary.
SCIENCE
HEALTH SCIENCE
NURSING

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