Cancer

Cancer Hospice Eligibility Information 

Cancer

LCD Guideline

Cancer

A. Disease with distant metastases at presentation

OR

B. Progression from an earlier stage of disease to metastatic disease with either:

  1. a continued decline despite therapy
  2. patient declines further disease directed therapy

Note: Certain cancers with poor prognoses (e.g. small cell lung cancer, brain cancer and pancreatic cancer) may be hospice eligible without fulfilling the other criteria in this section.

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Nurse assists patient with walker — Mesa, AZ — Noble Hospice and Palliative Care

Comparative Data

Increase in tumor size - Tumor was size of golf ball now size of softball

Decrease in activity - Was able to go out and enjoy activity, now staying in room Comorbidities - CHF, COPD, ETC

Decrease in intake - Was eating 100% of meals 1 month ago, now eating only one meal a day, complains of change in taste

Weight Change, Anorexia

Depression and Anxiety - Was very social interacting with people, now staying in room, not talkative

Medication changes - Add anxiety medication, depression medication

Increase in Pain - Change in pain intensity, interferes with activity

Change in ADL’s - Needs assistance with bathing, needs assistance with dressing, PPS was 60% 2 months ago today, PPS 40%, increased weakness

Change in Skin - Pallor, lesions, wounds, nonhealing wounds, dusky, bruising

Comorbidities

  • Kidney failure
  • Pain
  • SOB
  • Bleeding
  • Skin Problems
  • Anorexia
  • Ascites

Contact us today at 480-868-2845 if you have questions about cancer eligibility guidelines. 

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