When did a newly diagnosed creatinine of 4.5 not become an indication for admission to the hospital? Why did I just have to spend 20 minutes arguing with the medical director of an insurance company that payment for my patient's admission should not have been denied? ("The patient did not need to be admitted. The creatinine was not greater than 5, which is our guideline for hospital admission. You are welcome to appeal our decision.")
Why did I have to convince him that the increased creatinine was truly acute, likely due to interstitial nephritis from an antibiotic, and we had no way of knowing whether he would get worse, need a kidney biopsy, and require high dose steroids?
Eventually, payment for the admission was granted, which is the only reason I'm not naming names.
And the patient did fine and the renal failure resolved.
But am I pissed off.
