Must meet all criteria.
- Must have the following conditions documented:
- Disabling dyspnea at rest
- Poor response to bronchodilators
- Decreased functional capacity (e.g. bed to chair existence, fatigue, and cough).
- FEV1 <30% is objective evidence for disabling dypnea but is not required.
- Progression of disease as evidenced by a recent history of increased visits to PCP office, home visits, or ER and/or hospitalizations for pulmonary infections and/or respiratory failure
- Documentation within the past (3) months of either/both of the following:
- Hypoxemia at rest (pO2<55 mgHg by ABG) or oxygen saturation <88%
- Hypercapnia evidenced by pCO2>50mm Hg
- Cor pulmonale and right heart failure secondary to pulmonary disease
- Unintentional progressive weight loss >10% over the preceeding (6) months
Resting tachycardia >100 bpm
See another guide:
Heart Disease/CHF (Congestive Heart Failure)
Neurological Diseases (see list below)
ALS (Amyotrophic Lateral Sclerosis)
MS (Multiple Sclerosis)
Renal (Kidney) Failure
Frequent Co-Morbidity documentation requirements
Cachexia/Protein Calorie Malnutrition (Weight Loss)