Claimant #12 CPT: $45,928-Lou Gehrig's
disease. Spec is $100k 24/12
This patient has ALS (Lou Gehrig's Disease) and may need a review of underwriting and possible stop loss underwriting. This patient is about
62 years old and his main symptom had been lower extremity weakness.
He is progressing to upper extremity weakness. He requires a wheelchair
at this point. His lung capacity is fine and he has minimal
swallowing difficulty.
ALS has no cure and the disease will continue to progress. It
will more fully involve his upper extremities, swallowing and breathing. It
is a terminal illness. The patient may decide to have a feeding tube
placed if he can't swallow, but most patients do not opt for very
aggressive care, like the vent, due to the incurable aspect.
AMS Recommendation:
Let patient go at spec for
supportive care in the upcoming period.
Back To Case Studies
|
