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Weight loss of at least 10% body weight in the prior 6 months, not due to reversible causes (eg, depression or use of diuretics) Decreasing anthropomorphic measurements (mid-arm circumference, abdominal girth), not due to reversible causes (eg, depression or use of diuretics)
Cancer, heart disease, dementia, lung disease, and stroke are five common diagnoses seen in hospice patients. However, that does not mean that hospice programs are exclusive only to patients with those conditions.
This LCD describes guidelines to be used by National Government Services (NGS) in reviewing hospice claims and by hospice providers to determine eligibility of beneficiaries for hospice benefits. Although guidelines applicable to certain disease categories are included, this LCD is applicable to all hospice patients.
Poor nutritional with inability to maintain sufficient fluid and caloric intake with either: - 10% weight loss over the previous six months - 7.5% weight loss over the previous three months - Serum albumin
The higher a persons BMI, the less likely he or she was to enter hospice. Someone who had a BMI of 40 had less than a 23 percent chance of having hospice services at the end of life, while those in the normal weight, with a BMI of 20, had a 38 percent chance, the researchers found.
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Hospice eligibility requirements: Progressive weight loss (taking into consideration edema weight) Increasing weakness, fatigue, and somnolence. A change in cognitive and functional abilities. Compromised Activities of Daily Living (ADLs) such as eating, bathing, dressing, toileting, transferring/walking, and
LCDs are decisions made by a Medicare Administrative Contractor (MAC) whether to cover a particular item or service in a MACs jurisdiction (region) in ance with section 1862(a)(1)(A) of the Social Security Act.
A patient must present at least 7a (limited ability to speak, typically 1-5 words a day), as well as the symptoms of Stage 6 (in particular difficulty with dressing, bathing, and continence), to be considered appropriate for hospice.

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