The document is broken into multiple sections. and the State Children's Health Insurance Programs, contracts with certain organizations to assist in the administration of the
You shall not remove, alter, or obscure any ADA copyright notices or other proprietary rights notices included in the materials. 100-02), Ch. For a patient to be eligible for hospice, consider the following guidelines: The illness is terminal (a prognosis of 6 months) and the patient and/or family has elected palliative care. "JavaScript" disabled. The ADA expressly disclaims responsibility for any consequences or liability attributable to or related to any use, non-use, or interpretation of information contained or not contained in this file/product. CPT is provided "as is" without warranty of any kind, either expressed or implied, including but not limited to, the implied warranties of merchantability and fitness for a particular purpose. PFC 2.6 Documentation supports the patient's continuing terminal prognosis and eligibility. The views and/or positions presented in the material do not necessarily represent the views of the AHA. Special Physician Services Hospice providers must use revenue code 0657 when billing for pain- and Please visit the, Other (Bill type and/or revenue code removal). Jurisdiction M Home Health and Hospice MAC. Applications are available at the AMA website. The AMA assumes no liability for data contained or not contained herein. Any questions pertaining to the license or use of the CDT-4 should be addressed to the ADA. LCD Title. Part II is related to the functional limitations of a beneficiary, and is used in conjunction with the disease specific appendices. The AMA does not directly or indirectly practice medicine or dispense medical services. LCDs provide guidance in determining medical necessity of services. 100-01, Medicare General Information, Eligibility, and Entitlement Manual, Chapter 1, 10.1 Hospital Insurance (Part A) for Inpatient Hospital, Hospice, Home Health, and Skilled Nursing Facility (SNF) Services - A Brief Description, CMS Internet-Only Manual, Pub. Bookmark |
If you do not agree to the terms and conditions, you may not access or use the software. 7500 Security Boulevard, Baltimore, MD 21244. This Agreement will terminate upon notice if you violate its terms. 2022 Webinar Recordings. Empowering Home Care & Hospice Agencies to Achieve Success. Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CDT for resale and/or license, transferring copies of CDT to any party not bound by this agreement, creating any modified or derivative work of CDT, or making any commercial use of CDT. CPT is a trademark of the American Medical Association (AMA). Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CDT-4 for resale and/or license, transferring copies of CDT-4 to any party not bound by this agreement, creating any modified or derivative work of CDT-4, or making any commercial use of CDT-4. There are multiple ways to create a PDF of a document that you are currently viewing. The ADA does not directly or indirectly practice medicine or dispense dental services. The AMA is a third party beneficiary to this Agreement. Hospice care for heart disease addresses a wide range of symptoms, including shortness of breath, chest pain, weakness, functional decline and the management of fluid status. Comorbid conditions affecting beneficiaries with cardiopulmonary conditions are, by definition, distinct from the primary condition itself. The AMA does not directly or indirectly practice medicine or dispense medical services. An example of a comorbid condition would be End Stage Renal Disease (ESRD). In the case of cardiopulmonary conditions, examples of secondary conditions could include delirium, pneumonia, stasis ulcers, and pressure ulcers. Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CPT for resale and/or license, transferring copies of CPT to any party not bound by this agreement, creating any modified or derivative work of CPT, or making any commercial use of CPT. The patient should have a prognosis of fewer than six months if the disease runs its normal course, as determined . Local Coverage Determinations (LCDs) contain specific information guidelines about how Palmetto GBA covers some procedures. The AMA disclaims responsibility for any consequences or liability attributable to or related to any use, non-use, or interpretation of information contained or not contained in this file/product. The agency then must understand what services are covered, and how to document these services. AS USED HEREIN, "YOU" AND "YOUR" REFER TO YOU AND ANY ORGANIZATION ON BEHALF OF WHICH YOU ARE ACTING. , Medicare Benefit Policy Manual (CMS Pub. In no event shall CMS be liable for direct, indirect, special, incidental, or consequential damages arising out of the use of such information or material. The MAC's decision is based on whether the . Sign up to get the latest information about your choice of CMS topics in your inbox. Hospice referrals should balance a physician's experienced clinical judgement, Medicare regulations, and input from the patient and family. CMS Medicare Learning Network (MLN) Published 07/01/2017. This Agreement will terminate upon notice to you if you violate the terms of this Agreement. End User/Point and Click Agreement: CPT codes, descriptions and other data only are copyright 2009 American Medical Association (AMA). The occurrence of secondary conditions in beneficiaries with AD is facilitated by the presence of impairments in such body functions as mental functioning and movement functions. CMS DISCLAIMS RESPONSIBILITY FOR ANY LIABILITY ATTRIBUTABLE TO END USER USE OF THE CPT. This section states: "For purposes of this section, the term 'local coverage determination' means a determination by a fiscal intermediary or a carrier under part A or part B, as applicable, respecting whether or not a particular item or service is covered on an . Community Guidelines (Arabic) etina . Email |
At this time 21st Century Cures Act will apply to new and revised LCDs that restrict coverage which requires comment and notice. Press Done after you finish the document. such information, product, or processes will not infringe on privately owned rights. Documentation meeting the criteria listed under the Coverage Indications, Limitations and/or Medical Necessity section of this Local Coverage Determination (LCD) would contribute to this requirement. No fee schedules, basic unit, relative values or related listings are included in CPT. The sole responsibility for the software, including any CDT-4 and other content contained therein, is with (insert name of applicable entity) or the CMS; and no endorsement by the ADA is intended or implied. Reproduced with permission. small cell lung cancer, brain cancer and pancreatic cancer) may be hospice eligible without fulfilling the other criteria in this section. Please. Please note that if you choose to continue without enabling "JavaScript" certain functionalities on this website may not be available. Join to apply for the Professional Medical Coder I role at Lexington Hospice Services. Hospice Election Requirements. If an entity wishes to utilize any AHA materials, please contact the AHA at 312‐893‐6816. 7500 Security Boulevard, Baltimore, MD 21244. Use is limited to use in Medicare, Medicaid or other programs administered by the Centers for Medicare and Medicaid Services (CMS). Punctuation was corrected throughout the policy. Instead, you must click below on the button labeled "I DO NOT ACCEPT" and exit from this computer screen. copied without the express written consent of the AHA. click here to see all U.S. Government Rights Provisions, 26 Century Blvd Ste ST610, Nashville, TN 37214-3685. Please visit the, Risk Identified by a Zone Program Integrity Contractor (ZPIC), Other (Bill type and/or revenue code removal). This product includes CPT which is commercial technical data and/or computer data bases and/or commercial computer software and/or commercial computer software documentation, as applicable which were developed exclusively at private expense by the American Medical Association, 515 North State Street, Chicago, Illinois, 60610. Palliative care is a resource for anyone living with a serious illness, such as heart failure, chronic obstructive pulmonary disease, cancer, dementia, Parkinson's disease, and many others. You agree to take all necessary steps to insure that your employees and agents abide by the terms of this agreement. The Centers for Medicare & Medicaid Services (CMS), the federal agency responsible for administration of the Medicare, Medicaid
If your session expires, you will lose all items in your basket and any active searches. Formatting, punctuation and typographical errors were corrected throughout the LCD. Before sharing sensitive information, make sure you're on a federal government site. Estimated glomerular filtration rate (GFR) <10 ml/min. You agree to take all necessary steps to insure that your employees and agents abide by the terms of this agreement. Ultimately, the combined effects of the AD (FAST stage 7 and beyond) and any secondary condition should be such that most beneficiaries with AD and similar impairments would have a prognosis of months or less.The documentation of structural/functional impairments and activity limitations facilitate the selection of intervention strategies (palliative vs. curative) and provide objective criteria for determining the effects of such interventions. Instructions for enabling "JavaScript" can be found here. The information displayed in the Tracking Sheet is pulled from the accompanying Proposed LCD and its correlating Final LCD and will be updated as new data becomes available. By clicking below on the button labeled "I accept", you hereby acknowledge that you have read, understood and agreed to all terms and conditions set forth in this agreement. All coding located in the Coding Information section has been moved into the related Billing and Coding: Hospice Alzheimers Disease & Related Disorders A56639 article and removed from the LCD. without the written consent of the AHA. The information displayed in the Tracking Sheet is pulled from the accompanying Proposed LCD and its correlating Final LCD and will be updated as new data becomes available. The disease-specific LCD guideline: Alzheimer's disease and Related Conditions for hospice should be used when determining hospice eligibility. All rights reserved. click here to see all U.S. Government Rights Provisions, Certification/Recertification Requirements, Hospice Face-to-Face Encounter Calendar Quick Resource Tool, Eligibility of Beneficiaries in a Skilled Nursing Facility, Hospice and End Stage Renal Disease (ESRD), Hospice Local Coverage Determination (LCD), Hospice Face-to-Face (FTF) Encounters Frequently Asked Questions (FAQs), Hospice Program for Evaluating Payment Patterns Electronic Report (PEPPER), 26 Century Blvd Ste ST610, Nashville, TN 37214-3685. authorized with an express license from the American Hospital Association. An asterisk (*) indicates a
You agree to take all necessary steps to ensure that your employees and agents abide by the terms of this agreement. MACs develop an LCD when there is no national coverage determination (NCD) (e.g., when an item or service is new) or when there is a need to further define an NCD for the specific jurisdiction. Use is limited to use in Medicare, Medicaid or other programs administered by the Centers for Medicare and Medicaid Services (CMS). Identify the NCDs, LCDs and LCAs that apply to the Home Health/Hospice services. Applicable FARS\DFARS Restrictions Apply to Government Use. Summary. Apr 2021 - Jun 2022 1 year 3 months. LCDs outline how the contractor will review claims to ensure that the services provided meet Medicare coverage requirements. Now it is possible to print, save, or share the document. The guidelines for LCD development are provided in Chapter 13 of the Medicare Program Integrity Manual. Hospice care is a comprehensive home care program which primarily provides medical and support services for terminally ill patients. All Citations were moved from the Sources of Information and Basis for Decision section to the Bibliography section. CDT-4 is provided "as is" without warranty of any kind, either expressed or implied, including but not limited to, the implied warranties of merchantability and fitness for a particular purpose. This resource can be a teaching tool for new employees and hospice managers. THE LICENSE GRANTED HEREIN IS EXPRESSLY CONDITIONED UPON YOUR ACCEPTANCE OF ALL TERMS AND CONDITIONS CONTAINED IN THIS AGREEMENT. Applications are available at the AMA Web site, http://www.ama-assn.org/go/cpt. This license will terminate upon notice to you if you violate the terms of this license. For example a beneficiary with AD and clinically significant CHD or COPD would have specific impairments of cardiorespiratory function (e.g., dyspnea, orthopnea, wheezing, chest pain), which may or may not respond or be amenable to treatment. Instructions for enabling "JavaScript" can be found here. Any questions pertaining to the license or use of the CPT must be addressed to the AMA. Please enable "JavaScript" and revisit this page or proceed with browsing CMS.gov with
The license granted herein is expressly conditioned upon your acceptance of all terms and conditions contained in this agreement. This email will be sent from you to the
The American Hospital Association (the "AHA") has not reviewed, and is not responsible for, the completeness or
The link to the Reconsideration Process must be used for any suggested changes to the Centers for Medicare & Medicaid Services (CMS). Learn about hospice guidelines for your patients with end-stage heart disease, including CHF, and download a PDF of these guidelines for easy reference. The ADA is a third-party beneficiary to this Agreement. Before an LCD becomes final, the MAC publishes Proposed LCDs, which include a public comment period. No fee schedules, basic unit, relative values or related listings are included in CDT-4. No portion of the American Hospital Association (AHA) copyrighted materials contained within this publication may be
For bulk orders of 25 or more, please contact Corridor at 1-866-263-3795. 9, 10, 20.2.1 and 40.1.3.1. recipient email address(es) you enter. Another option is to use the Download button at the top right of the document view pages (for certain document types). Double check all the fillable fields to ensure complete accuracy. IF YOU ARE ACTING ON BEHALF OF AN ORGANIZATION, YOU REPRESENT THAT YOU ARE AUTHORIZED TO ACT ON BEHALF OF SUCH ORGANIZATION AND THAT YOUR ACCEPTANCE OF THE TERMS OF THIS AGREEMENT CREATES A LEGALLY ENFORCEABLE OBLIGATION OF THE ORGANIZATION. Is used by CGS Medical Review staff as a guideline to aide in consistency of reviews. Applications are available at the American Dental Association web site. Hunter Business School Graduate. Use of CDT is limited to use in programs administered by Centers for Medicare & Medicaid Services (CMS). Spiral-bound. Comorbid Conditions:The significance of a given comorbid condition is best described by defining the structural/functional impairments together with any limitation in activity and restriction in participation related to the comorbid condition. National Vital Statistics 2. PPS <70% 3. Meets most of the LCD criteria AND has documented rapid clinical decline supporting a limited prognosis 3. Title XVIII of the Social Security Act, 1813(a)(4) addresses drugs and biologicals provided in a hospice program. Under Coverage Indications, Limitations and/or Medical Necessity changed each of the words scale to lower case in the second paragraph, removed bold lettering from the Stage #7 subheading, and changed the slash to or in the paragraph titled Comorbid Conditions. CMS DISCLAIMER. Utilize the Sign Tool to add and create your electronic signature to signNow the ALS Hospice LCD for Determining Terminal Status Worksheet CGS (updated 11/2014) form. This revision is not a restriction to the coverage determination; and, therefore not all the fields included on the LCD are applicable as noted in this policy. No fee schedules, basic unit, relative values or related listings are included in CPT. Determining Eligibility. Resting tachycardia >100/min. Documentation RequirementsDocumentation certifying terminal status must contain enough information to confirm terminal status upon review. These materials contain Current Dental Terminology, Fourth Edition (CDT), copyright 2002, 2004 American Dental Association (ADA). License to use CPT for any use not authorized herein must be obtained through the AMA, CPT Intellectual Property Services, AMA Plaza 330 N. Wabash Ave., Suite 39300, Chicago, IL 60611-5885. Clinical findings of malignancy with widespread, aggressive or progressive disease as evidenced by increasing sx, worsening lab values and/or evidence of metastatic disease 2. The responsibility for the content of this file/product is with CMS and no endorsement by the AMA is intended or implied. Clinics in Geriatric Medicine. You agree to take all necessary steps to ensure that your employees and agents abide by the terms of this agreement. All rights reserved. CMS and its products and services are not endorsed by the AHA or any of its affiliates. CPT is provided "as is" without warranty of any kind, either expressed or implied, including but not limited to, the implied warranties of merchantability and fitness for a particular purpose. n to the coverage determination; and, therefore not all the fields included on the LCD are applicable as noted in this policy. (2015). Inability to maintain hydration and caloric intake with 1 of the following: weight loss >10% in the last 6 months or >7. . documentation. 100-01, Medicare General Information, Eligibility, and Entitlement Manual, Chapter 5, 60 Hospice Defined, CMS Internet-Only Manual, Pub. Neurology. Their impact on any given individual depends on the individuals overall health status. required field. Any questions pertaining to the license or use of the CPT must be addressed to the AMA. To submit a comment or question to CMS, please use the Feedback/Ask a Question link available at the bottom
This Agreement will terminate upon notice if you violate its terms. Hospice Documentation Tips; Implementation of the Election Statement Addendum; Hospice Beneficiary Election Statement Addendum Frequently Asked Questions; Hospice Levels of Care: General Inpatient Care; Documentation for Hospice Transfers; Tips for Responding to a Hospice ADR; Documentation Requirements for the Medicare Hospice Election Statement Use of the International Classification of Functioning, Disability and Health (ICF) to help identify and document the unique service needs of individuals with cardiopulmonary conditions is suggested, but not required.The health status changes associated with cardiopulmonary conditions can be characterized using categories contained in the ICF. These materials contain Current Dental Terminology (CDTTM), copyright© 2022 American Dental Association (ADA). Please review and accept the agreements in order to view Medicare Coverage documents, which may include licensed information and codes. Stroke or coma. J Palliat Med. You are leaving the CMS MCD and are being redirected to the CMS MCD Archive that contains outdated (No Longer In Effect) Local Coverage Determinations and Articles, You are leaving the CMS MCD and are being redirected to, For services performed on or after 10/01/2015, For services performed on or after 11/04/2021, AMA CPT / ADA CDT / AHA NUBC Copyright Statement, Coverage Indications, Limitations, and/or Medical Necessity, Analysis of Evidence (Rationale for Determination), This LCD is being revised in order to adhere to CMS requirements per chapter 13, section 13.5.1 of the Program Integrity Manual, to remove all coding from LCDs. If the foregoing terms and conditions are acceptable to you, please indicate your agreement by clicking below on the button labeled "I ACCEPT". CMS NCDs are available on the Medicare Coverage Ultimately, in order to support a hospice plan of care, the combined effects of the primary cardiopulmonary condition and any identified comorbid condition(s), should be such that most beneficiaries with the identified impairments would have a prognosis of6 months or less.The documentation of structural/functional impairments and activity limitations facilitate the selection of the most appropriate intervention strategies (palliative/hospice versus long-term disease management), and provide objective criteria for determining the effects of such interventions. What is an LCD? Experienced Registered Medical Assistant with a demonstrated history of working in the hospital & health care industry. In no event shall CMS be liable for direct, indirect,
Under Bibliography changes were made to citations to reflect AMA citation guidelines. Home Health and Hospice providers in Alabama, Arkansas, Florida, Georgia, Illinois, Indiana, Kentucky, Louisiana, Mississippi, New Mexico, North Carolina, Ohio, Oklahoma, South Carolina, Tennessee and Texas. A Local Coverage Determination (LCD) is a decision made by a Medicare Administrative Contractor (MAC) on whether a particular service or item is reasonable and necessary, and therefore covered by Medicare within the specific jurisdiction that the MAC oversees. These materials contain Current Dental Terminology, Fourth Edition (CDT), copyright 2002, 2004 American Dental Association (ADA). All Rights Reserved. The basis for LCDs is Section 1862 (a) (1) (A) of the Social Security Act. Why hospice now? This page displays your requested Local Coverage Determination (LCD). Summary: For beneficiaries with AD to be eligible for hospice the individual should have a FAST level of greater than or equal to 7 and specific comorbid or secondary conditions meeting the above criteria. If the patient meets the LCD criteria of both 1 and 2 below then the criteria for a six month or less prognosis is met. Stroke and Coma. CPT is a trademark of the AMA. Hospice is a medical service based on a holistic approach to providing quality end-of-life care to patients. Applicable FARS\DFARS Restrictions Apply to Government Use. The important roles of secondary and comorbid conditions are described below, in order to facilitate their recognition and assist providers in documenting their impact. The responsibility for the content of this file/product is with CGS or the CMS and no endorsement by the AMA is intended or implied. The responsibility for the content of this file/product is with CGS or the CMS and no endorsement by the AMA is intended or implied. CMS DISCLAIMS RESPONSIBILITY FOR ANY LIABILITY ATTRIBUTABLE TO END USER USE OF THE CPT. PFC 2.5 The hospice team delineates a process to transition family members and caregivers from patient care to bereavement care. AS USED HEREIN, "YOU" AND "YOUR" REFER TO YOU AND ANY ORGANIZATION ON BEHALF OF WHICH YOU ARE ACTING. Frontotemporal dementia. Hospice Regulatory Boot Camp and Specialty Topics for Hospice Professionals. Current Dental Terminology © 2022 American Dental Association. There has been no change in coverage with this LCD revision. Meets most of the LCD criteria AND has significant comorbidities that contribute to a limited prognosis 4. 9. Should the foregoing terms and conditions be acceptable to you, please indicate your agreement and acceptance by clicking below on the button labeled "I Accept". National Coverage Determinations (NCDs) NCDs. If a patient meets the medical criteria above, they are by definition eligible for hospice services. Non-disease-specific baseline guidelines (both A and B should be met) A. Physiologic impairment of functional status as demonstrated by KPS or PPS <70%. Please do not use this feature to contact CMS. This revision is not a restriction to the coverage determination; and, therefore not all the fields included on the LCD are applicable as noted in this policy. Print |
The AMA is a third party beneficiary to this Agreement. This email will be sent from you to the
End User Point and Click Amendment:
Angel Hospice Lapel Pin - Silver (Super Sale) These adorable 1"x 1" pins are perfect for any holiday lapel. As used herein, "you" and "your" refer to you and any organization on behalf of which you are acting. Healthcare Provider Solutions. Per CMS Internet-Only Manual, Pub 100-08, Medicare Program Integrity Manual, Chapter 13, 13.1.3 LCDs consist of only reasonable and necessary information. . Neither the United States Government nor its employees represent that use of
The Tracking Sheet provides key details about the Proposed LCD, including a summary of the issue, who requested the new/updated policy, links to key documents, important process-related dates, who to contact with questions about the policy, and the history of previous policy considerations. Some older versions have been archived. Font Size:
If you are acting on behalf of an organization, you represent that you are authorized to act on behalf of such organization and that your acceptance of the terms of this agreement creates a legally enforceable obligation of the organization. If you are experiencing any technical issues related to the search, selecting the 'OK' button to reset the search data should resolve your issues. Symptoms of end-stage Parkinson's disease include very limited mobility, extremely slow movements, falls, and cognitive and psychotic problems. Medicare contractors are required to develop and disseminate Local Coverage Determinations (LCDs). Section II: Non-Cancer Diagnoses. Medicare Benefit Policy Manual (CMS Pub. License to use CDT for any use not authorized herein must be obtained through the American Dental Association, 211 East Chicago Avenue, Chicago, IL 60611. Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CDT-4 for resale and/or license, transferring copies of CDT-4 to any party not bound by this agreement, creating any modified or derivative work of CDT-4, or making any commercial use of CDT-4. End users do not act for or on behalf of the CMS. Covid-19 Home Health Hospice Review Choice Demo. CMS believes that the Internet is an effective method to share LCDs that Medicare contractors develop. License to use CPT for any use not authorized here in must be obtained through the AMA, CPT Intellectual Property Services, 515 N. State Street, Chicago, IL 60610. This revision is not a restrictio. Note that 2 of the disease-specific guidelines (HIV and stroke/coma) establish a lower qualifying KPS or PPS. THE INFORMATION, PRODUCT, OR PROCESSES DISCLOSED HEREIN. The sole responsibility for the software, including any CDT-4 and other content contained therein, is with (insert name of applicable entity) or the CMS; and no endorsement by the ADA is intended or implied. Geldmacher DS. Patients will be considered to be in the terminal stages of stroke or coma (life expectancy of 6 months or less) if they meet the following criteria: Stroke: KPS or Palliative Performance Scale of 40% or less. "Either you lift people up by respecting them, making them feel valued, appreciated and heard or you hold people down by making them feel small Patients with neurological diseases may be eligible for hospice when they experience the following signs or symptoms: Severely compromised breathing, marked by inability to clear respiratory secretions, persistent cough, or recurring aspiration pneumonia. Consider all factors that impact the patient's prognosis. The ADA expressly disclaims responsibility for any consequences or liability attributable to or related to any use, non-use, or interpretation of information contained or not contained in this file/product. End User Point and Click Amendment:
Please note that codes (CPT/HCPCS and ICD-10) have moved from LCDs to Billing & Coding Articles. BY CLICKING BELOW ON THE BUTTON LABELED "I ACCEPT", YOU HEREBY ACKNOWLEDGE THAT YOU HAVE READ, UNDERSTOOD AND AGREED TO ALL TERMS AND CONDITIONS SET FORTH IN THIS AGREEMENT. Kochanek K., Murphy S., Xu J., Arias E. (2017). 2007;10(1):210-228. Please note that codes (CPT/HCPCS and ICD-10) have moved from LCDs to Billing & Coding Articles. THE UNITED STATES GOVERNMENT AND ITS EMPLOYEES ARE NOT LIABLE FOR ANY ERRORS, OMISSIONS, OR OTHER INACCURACIES IN
Health status includes measures of functioning, physical illness, and mental well-being, as well as, environmental factors, such as the availability of palliative care services. In addition to improving quality of life and . Applicable Federal Acquisition Regulation Clauses (FARS)/Department of Defense Federal Acquisition Regulation supplement (DFARS) Restrictions Apply to Government Use. If you would like to extend your session, you may select the Continue Button. Please review and accept the agreements in order to view Medicare Coverage documents, which may include licensed information and codes. The Centers for Medicare & Medicaid Services (CMS), the federal agency responsible for administration of the Medicare, Medicaid
MACs are Medicare contractors that develop LCDs and process Medicare claims. of every MCD page. Regulations regarding billing and coding were removed from the, At this time 21st Century Cures Act will apply to new and revised LCDs that restrict coverage which requires comment and notice. This should be the question answered for all hospice admission. Ultimately, in order to support a hospice plan of care, the combined effects of the primary cardiopulmonary condition and any identified secondary condition(s) should be such that most beneficiaries with the identified impairments would have a prognosis of6 months or less.