Cancer

Patient must meet all criteria:

  1. Clinical findings of malignancy with widespread, aggressive, or progressive disease as evidenced by increasing symptoms, worsening lab values, and/or evidence of metastatic disease.

    AND

  2. Palliative Performance Scale (PPS) < 70%

    AND

  3. Refuses further treatment or continues to decline in spite of treatment:
    1. Hypercalcemia > 12
    2. Cachexia or weight loss of 5% in past (3) months
    3. Recurrent disease after surgery/radiation/chemotherapy
    4. Signs or symptoms of advanced disease:
      1. nausea
      2. requirement for transfusions
      3. malignant ascites, or
      4. pleural effusion, etc.

Required documentation:

  1. Tissue diagnosis of malignancy, or
  2. Reason(s) why a tissue diagnosis is not available.
In the absence of one or more of the above findings, rapid decline or comorbidities may also support eligibility for hospice care.

Other guides:
Alzheimer’s/Dementia
CHF/Heart Disease
COPD/Pulmonary Disease
CVA /Stroke/Coma
HIV/AIDS
Huntington’s Disease
Liver Disease
Neurological Diseases 
      ALS (Amyotrophic Lateral Sclerosis)
      Parkinson’s
      Muscular Dystrophy
      Myasthenia Gravis
      MS (Multiple Sclerosis)
Renal Failure, Chronic or Acute

Assessment Tools
Palliative Performance Scale (PPS)
New York Heart Association (NYHA) Functional Classes
Functional Assessment Staging (FAST) Scale

Frequent Co-Morbidity documentation requirements
Cachexia or Protein Calorie Malnutrition

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