Hospice - Liver Disease

Medicare hospice coverage for liver disease requires a physician certification of life expectancy ≤6 months and evidence of advanced liver dysfunction including coagulopathy (PT >5 seconds over control or INR >1.5) plus low serum albumin and end-stage liver disease with at least one major complication (e.g., refractory ascites, SBP, hepatorenal syndrome, refractory hepatic encephalopathy, or recurrent variceal bleeding). Supporting factors (malnutrition, muscle wasting, heavy alcohol use >80 g/day, HCC, HBsAg positivity, or hepatitis C refractory to interferon) strengthen eligibility; patients awaiting transplant may be certified but must be discharged if a donor organ is procured.

"Physician certification that the patient's prognosis is life expectancy of six months or less if the terminal illness runs its normal course."

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