HOSPICE HEART
DISEASE
At the time of initial certification or re-certification for hospice
Patient is
already optimally treated with diuretics and vasodilators, which may include
angiotensin-converting enzymes (ACE) inhibitors or the combination of
hydralazine and nitrates. If side effects, such as hypotension or hyperkalemia,
prohibit the use of ACE inhibitors or the combination of hydralazine and
nitrates, this must be documented in the medical records OR
Patients having
angina pectoris, at rest, resistant to standard nitrate therapy the patient has
significant symptoms of recurrent congestive heart failure (CHF) at rest, and is
classified as a New York Heart Association (NYHA) Class IV:
Unable to carry
on any physical activity without symptoms
Symptoms are
present even at rest
If any physical
activity is undertaken, symptoms are increased
Documentation
of the following factors may provide additional support for end stage heart
disease:
Treatment
resistant symptomatic supraventricular or ventricular arrhythmias
History of
cardiac arrest or resuscitation
History of
unexplained syncope (A
brief loss of consciousness caused by a temporary deficiency of oxygen in the
brain; a swoon, blackout.)
Brain embolism
of cardiac origin
Concomitant HIV
disease
Documentation
of ejection fraction of 20% or less
If you have any
questions call
Grace Hospice
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