1. Prothrombine time prolonged > 5 seconds over control or INR>1.5
2. Serum Albumin < 2.5gm/dl
3. Patient shows at least one of the following
   1. Ascites, refractory to treatment or non-compliant
   2. Spontaneous bacterial peritonitis
   3. Elevated creatinine and BUN with oliguria (<400 cc/day) and urine sodium concentration (<10 mEq/l)
   4. Hepatic encephalopathy, refractory to treatment or non-compliant
   5. Recurrent variceal bleeding

These factors will support eligibility

1. Progressive malnutrition or muscle wasting with reduced strength
2. Active alcoholism (>80 gm ethanol.day)
3. Hepatocellular carcinoma
4. HbsAG positively – Hepatitis B
5. Hepatitis C refractory to treatment

Medicare Local Coverage Determination (LCD) for Liver Disease