1. Disabling Dyspnea at rest or unresponsive to bronchodilators
2. Increasing visits to the emergency department for pulmonary infections or respiratory failure
3. Hypoxemia as evidenced by pO2 < 55 or O2 sat < 88 % on O2 or hypercapnia as evidenced by pCO2 > 50

These factors will support eligibility

1. Cor pulmonale and right heart failure secondary to pulmonary disease
2. Unintentional weigh t loss >10% in previous 6 months
3. Resting tachycardia >100/min

Medicare Local Coverage Determination (LCD) for Cardiopulmonary Disease