This is your Ultimate Guide to the new VA ratings for digestive system conditions.

The VA either added a new Diagnostic Code (DC) or changed the rating criteria for 47 conditions in 38 CFR 4.114.

We’ve arranged the updates in order of DC and provided detailed explanations for the disability name as well as the new VA ratings and criteria to be aware of.

Note: The updates are effective May 19, 2024. Click here to read the new law.

Table of Contents

List of the 47 VA Disability Digestive System Updates

DC 7200, Soft tissue injury of the mouth, other than tongue or lips
DC 7201, Lips, injuries of
DC 7202, Tongue, loss of whole or part
DC 7203, Esophagus, stricture of
DC 7204, Esophageal motility disorder
DC 7205, Esophagus, diverticulum of, acquired
DC 7206, Gastroesophageal reflux disease (GERD)
DC 7207, Barrett’s esophagus
DC 7301, Peritoneum, adhesions of, due to surgery, trauma, disease, or infection
DC 7303, Chronic complications of upper gastrointestinal surgery
DC 7304, Peptic ulcer disease
DC 7307, Gastritis, chronic
DC 7308, Postgastrectomy syndrome
DC 7309, Stomach, stenosis of
DC 7310, Stomach, injury of, residuals
DC 7312, Cirrhosis of the liver
DC 7314, Chronic biliary tract disease
DC 7315, Cholelithiasis, chronic
DC 7317, Gallbladder, injury of
DC 7318, Cholecystectomy (gallbladder removal), complications of (such as strictures and biliary leaks)
DC 7319, Irritable bowel syndrome (IBS)
DC 7323, Colitis, ulcerative
DC 7325, Enteritis, chronic
DC 7326, Crohn’s disease or undifferentiated form of inflammatory bowel disease
DC 7327, Diverticulitis and diverticulosis
DC 7328, Intestine, small, resection of
DC 7329, Intestine, large, resection of
DC 7330, Intestinal fistulous disease, external
DC 7332, Rectum and anus, impairment of sphincter control
DC 7333, Rectum and anus, stricture of
DC 7334, Rectum, prolapse of
DC 7335, Ano, fistula in, including anorectal fistula and anorectal abscess:
DC 7336, Hemorrhoids, external or internal
DC 7337, Pruritus ani (anal itching)
DC 7338, Hernia, including femoral, inguinal, umbilical, ventral, incisional, and other (but not including hiatal)
DC 7344, Benign neoplasms, exclusive of skin growths
DC 7345, Chronic liver disease without cirrhosis
DC 7346, Hiatal hernia and paraesophageal hernia
DC 7347, Pancreatitis, chronic
DC 7348, Vagotomy with pyloroplasty or gastroenterostomy
DC 7350, Liver abscess
DC 7351, Liver transplant
DC 7352, Pancreas transplant
DC 7354, Hepatitis C (or non-A, non-B hepatitis)
DC 7355, Celiac disease
DC 7356, Gastrointestinal dysmotility syndrome
DC 7357, Post pancreatectomy syndrome

DC 7200, Soft tissue injury of the mouth, other than tongue or lips:

Rate as for disfigurement (diagnostic codes 7800 and 7804) and impairment of mastication.

Explanation of terms:

Disfigurement refers to an alteration in physical appearance due to injury, disease, or congenital conditions. In the context of disability rating, it typically involves visible changes to the body that may impact a person’s self-esteem, social interactions, or ability to perform certain tasks.

Impairment of mastication: Mastication impairment refers to any condition or injury that affects a person’s ability to chew effectively. This impairment can result from various factors, including dental problems, jaw disorders, or neurological issues affecting the muscles involved in chewing.

DC 7201, Lips, injuries of:

Rate as disfigurement (diagnostic codes 7800 and 7804).

Explanation of terms:

DC 7202, Tongue, loss of whole or part:

Absent oral nutritional intake rate at 100%

Intact oral nutritional intake with permanently impaired swallowing function that requires prescribed dietary modification rate at 60%

Intact oral nutritional intake with permanently impaired swallowing function without prescribed dietary modification rate at 30%

Note (1): Rate the residuals of speech impairment as complete organic aphonia (DC 6519) or incomplete aphonia as laryngitis, chronic (DC 6516).

Note (2): Dietary modifications due to this condition must be prescribed by a medical provider.

Explanation of terms:

Absent oral nutritional intake rate at 100%: This means that if there’s a complete inability to take in nutrition orally due to the loss of the tongue, the disability rating is set at 100%. In other words, if the individual cannot eat or drink by mouth and relies entirely on alternative means of nutrition such as tube feeding, they would receive a disability rating of 100%.

Intact oral nutritional intake with permanently impaired swallowing function that requires prescribed dietary modification rate at 60%: If the individual can still take in nutrition orally but has permanently impaired swallowing function, necessitating dietary modifications prescribed by a medical provider, the disability rating is set at 60%.

Intact oral nutritional intake with permanently impaired swallowing function without prescribed dietary modification rate at 30%: If there’s intact oral nutritional intake despite permanently impaired swallowing function but without the need for prescribed dietary modifications, the disability rating is set at 30%.

Note (1): The residuals of speech impairment resulting from this condition should be rated separately using specific diagnostic codes, such as complete organic aphonia (DC 6519) or incomplete aphonia as chronic laryngitis (DC 6516). This means that any speech-related issues should be evaluated and rated separately from the swallowing function impairment related to the loss of the tongue.

Note (2): Any dietary modifications required due to this condition must be prescribed by a medical provider to be considered for rating purposes. This emphasizes that the need for dietary modifications should be documented and prescribed by a healthcare professional for rating assessment.

DC 7203, Esophagus, stricture of:

Documented history of recurrent or refractory esophageal stricture(s) causing dysphagia with at least one of the symptoms present: (1) aspiration, (2) undernutrition, and/or (3) substantial weight loss as defined by § 4.112(a) and treatment with either surgical correction or percutaneous esophago-gastrointestinal tube (PEG tube) rate at 80%

Documented history of recurrent or refractory esophageal stricture(s) causing dysphagia which requires at least one of the following (1) dilatation 3 or more times per year, (2) dilatation using steroids at least one time per year, or (3) esophageal stent placement rate at 50%

Documented history of recurrent esophageal stricture(s) causing dysphagia which requires dilatation no more than 2 times per year rate at 30%

Documented history of esophageal stricture(s) that requires daily medications to control dysphagia otherwise asymptomatic rate at 10%

Documented history without daily symptoms or requirement for daily medications rate at 0%

Note (1): Findings must be documented by barium swallow, computerized

tomography, or esophagogastroduodenoscopy.

Note (2): Non-gastrointestinal complications of procedures should be rated

under the appropriate system.

Note (3): This diagnostic code applies, but is not limited to, esophagitis, mechanical or chemical; Mallory Weiss syndrome (bleeding at junction of esophagus and stomach due to tears) due to caustic ingestion of alkali or acid; drug-induced or infectious esophagitis due to Candida, virus, or other organism; idiopathic eosinophilic, or lymphocytic esophagitis; esophagitis due to radiation therapy; esophagitis due to peptic stricture; and any esophageal condition that requires treatment with sclerotherapy.

Note (4): Recurrent esophageal stricture is defined as the inability to maintain target esophageal diameter beyond 4 weeks after the target diameter has been achieved.

Note (5): Refractory esophageal stricture is defined as the inability to achieve target esophageal diameter despite receiving no fewer than 5 dilatation sessions performed at 2-week intervals.

Explanation of terms:

Esophagus stricture refers to the narrowing (stricture) of the esophagus, the muscular tube that connects the throat to the stomach.

Documented history of recurrent or refractory esophageal stricture(s): Refers to cases where there is evidence in medical records of repeated instances of esophageal narrowing that either persist despite treatment (refractory) or keep occurring over time (recurrent).

Dysphagia: Difficulty swallowing, which can occur due to the narrowing of the esophagus. This may result in symptoms such as choking, coughing, or food getting stuck in the throat.

Aspiration: Inhaling food, liquids, or saliva into the airways instead of swallowing them into the esophagus. This can lead to respiratory issues such as pneumonia.

Undernutrition: Inadequate nutrition due to difficulty swallowing, leading to malnutrition or weight loss.

Substantial weight loss: A significant decrease in body weight over time, which may occur due to difficulty swallowing and subsequent undernutrition.

Surgical correction: Procedures performed to address the narrowing of the esophagus surgically.

Percutaneous esophago-gastrointestinal tube (PEG tube): A tube inserted through the skin into the stomach to provide nutrition or medication when swallowing is difficult or not possible.

Esophageal dilatation: Stretching or widening of the narrowed esophagus using medical instruments.

Esophageal stent placement: Insertion of a stent (a mesh tube) into the esophagus to keep it open and facilitate swallowing.

Notes:

Note (1): Findings related to esophageal stricture must be documented through specific medical imaging or procedures such as barium swallow, computerized tomography (CT), or esophagogastroduodenoscopy (EGD).

Note (2): Any complications arising from procedures performed to address esophageal stricture should be rated separately under the appropriate disability rating system.

Note (3): The diagnostic code applies to various conditions causing esophageal narrowing, including esophagitis, Mallory Weiss syndrome, drug-induced or infectious esophagitis, among others.

Note (4): Recurrent esophageal stricture is defined as the inability to maintain the

desired width of the esophagus beyond a certain period despite treatment.

Note (5): Refractory esophageal stricture is defined as the inability to achieve the desired width of the esophagus despite undergoing multiple dilatation sessions at regular intervals.

DC 7204, Esophageal motility disorder:

Rate as esophagus, stricture of (DC 7203).

Note: This diagnostic code applies, but is not limited to, achalasia (cardiospasm), diffuse esophageal spasm (DES), corkscrew esophagus, nutcracker esophagus, and other motor disorders of the esophagus; esophageal rings (including Schatzki rings), mucosal webs or folds, and impairment of the esophagus caused by systemic conditions such as myasthenia gravis, scleroderma, and other neurologic conditions.

Explanation of terms:

Esophageal motility disorder refers to conditions characterized by abnormal movement (motility) of the esophagus, the muscular tube that connects the throat to the stomach. Esophageal motility disorders can affect the normal functioning of swallowing and food passage.

Achalasia (cardiospasm): A disorder of the esophagus where the lower esophageal sphincter (LES) fails to relax properly during swallowing, leading to difficulty in passing food into the stomach.

Diffuse esophageal spasm (DES): A condition where abnormal contractions occur in the muscles of the esophagus, causing chest pain and difficulty swallowing.

Corkscrew esophagus: A term used to describe a pattern of abnormal contractions seen on esophageal motility studies, resembling the shape of a corkscrew.

Nutcracker esophagus: A condition characterized by abnormally strong contractions in the esophageal muscles during swallowing, leading to chest pain and difficulty swallowing.

Esophageal rings (including Schatzki rings): Narrow bands of tissue that encircle the esophagus, potentially causing swallowing difficulties or food impaction.

Mucosal webs or folds: Thin membranes or tissue folds in the lining of the esophagus that may cause narrowing and swallowing difficulties.

Impairment of the esophagus caused by systemic conditions: Refers to esophageal dysfunction secondary to underlying systemic conditions such as myasthenia gravis (a neuromuscular disorder), scleroderma (an autoimmune disease affecting connective tissue), and other neurological conditions affecting esophageal motility.

DC 7205, Esophagus, diverticulum of, acquired:

Rate as esophagus, stricture of (DC 7203).

Note: This diagnostic code, applies, but is not limited to, pharyngo- esophageal (Zenker’s) diverticulum, mid-esophageal diverticulum, and epiphrenic (distal esophagus) diverticulum.

Explanation of terms:

DC 7205, Esophagus, diverticulum of, acquired: This is a specific diagnostic code used for disability rating purposes. It refers to the presence of an acquired diverticulum in the esophagus. A diverticulum is an abnormal pouch or sac that forms in the wall of a hollow organ, such as the esophagus, due to weakened areas in the muscular wall.

Rate as esophagus, stricture of (DC 7203): This indicates that the disability rating for acquired esophageal diverticulum (DC 7205) is to be rated similarly to esophageal stricture (DC 7203), another diagnostic code used for rating esophageal conditions.

Note: The diagnostic code applies to various types of acquired esophageal diverticula, including pharyngo-esophageal (Zenker’s) diverticulum (occurring at the junction of the throat and esophagus), mid-esophageal diverticulum, and epiphrenic (distal esophagus) diverticulum. These diverticula can cause swallowing difficulties, regurgitation, and other symptoms depending on their location and size.

DC 7206, Gastroesophageal reflux disease (GERD):

Documented history of recurrent or refractory esophageal stricture(s) causing dysphagia with at least one of the symptoms present: (1) aspiration, (2) undernutrition, and/or (3) substantial weight loss as defined by § 4.112(a) and treatment with either surgical correction of esophageal stricture(s) or percutaneous esophago-gastrointestinal tube (PEG tube) rate at 80%

Documented history of recurrent or refractory esophageal stricture(s) causing dysphagia which requires at least one of the following (1) dilatation 3 or more times per year, (2) dilatation using steroids at least one time per year, or (3) esophageal stent placement rate at 50%

Documented history of recurrent esophageal stricture(s) causing dysphagia which requires dilatation no more than 2 times per year rate at 30%

Documented history of esophageal stricture(s) that requires daily medications to control dysphagia otherwise asymptomatic rate at 10%

Documented history without daily symptoms or requirement for daily medications rate at 0%

Note (1): Findings must be documented by barium swallow, computerized tomography, or esophagogastroduodenoscopy.

Note (2): Non-gastrointestinal complications of procedures should be rated under the appropriate system.

Note (4): Recurrent esophageal stricture is defined as the inability to maintain target esophageal diameter beyond 4 weeks after the target diameter has been achieved.

Note (5): Refractory esophageal stricture is defined as the inability to achieve target esophageal diameter despite receiving no fewer than 5 dilatation sessions performed at 2-week intervals.

Explanation of terms:

Gastroesophageal Reflux Disease (GERD): A chronic condition where stomach acid flows back into the esophagus, causing irritation and symptoms such as heartburn, regurgitation, and difficulty swallowing.

Documented history of recurrent or refractory esophageal stricture(s) causing dysphagia: Refers to cases where there’s evidence in medical records of repeated or difficult-to-treat narrowing of the esophagus leading to difficulty swallowing (dysphagia).

Aspiration, undernutrition, and/or substantial weight loss: These are symptoms often associated with severe GERD complications, indicating that the condition is affecting the patient’s ability to eat and maintain proper nutrition.

Surgical correction of esophageal strictures or percutaneous esophago-gastrointestinal tube (PEG tube): Treatment options for severe esophageal strictures caused by GERD may include surgical procedures to widen the esophagus or the placement of a feeding tube through the skin into the stomach (PEG tube) to ensure adequate nutrition.

Dilatation using steroids or esophageal stent placement: These are interventions used to widen narrowed areas of the esophagus. Dilatation involves the insertion of a balloon or other devices to stretch the esophagus, while steroid injections or the placement of stents may be used to reduce inflammation and maintain the opening.

Daily medications to control dysphagia: Refers to the need for ongoing medication to manage symptoms of dysphagia caused by GERD-related esophageal strictures.

Barium swallow, computerized tomography, or esophagogastroduodenoscopy (EGD): These are diagnostic tests used to visualize the esophagus and assess its structure and function.

Non-gastrointestinal complications of procedures: Refers to potential complications that may arise from treatments such as surgical correction, dilatation, or stent placement, which should be rated separately if they occur.

Recurrent and refractory esophageal strictures: Defined as the inability to maintain or achieve the desired diameter of the esophagus despite treatment, indicating the severity and chronicity of the condition.

DC 7207, Barrett’s esophagus:

With esophageal stricture: Rate as esophagus, stricture of (DC 7203).

Without esophageal stricture with documented by pathologic diagnosis with high-grade dysplasia rate at 30%

Without esophageal stricture documented by pathologic diagnosis with low-grade dysplasia rate at 10%

Note (1): If malignancy develops, rate as malignant neoplasms of the digestive system, exclusive of skin growths (DC 7343).

Note (2): If the condition is resolved via surgery, radiofrequency ablation, or other treatment, rate residuals as esophagus, stricture of (DC 7203).

Explanation of terms:

Barrett’s Esophagus: A condition where the tissue lining the esophagus is replaced by tissue similar to the lining of the intestine, typically due to long-standing gastroesophageal reflux disease (GERD).

Esophageal Stricture: Narrowing of the esophagus due to scarring or inflammation, which can lead to difficulty swallowing.

Pathologic Diagnosis with High-Grade Dysplasia: Refers to the microscopic examination of tissue samples from the esophagus showing abnormal cell changes that are more severe and potentially precancerous.

Pathologic Diagnosis with Low-Grade Dysplasia: Indicates abnormal cell changes in the esophageal tissue that are less severe compared to high-grade dysplasia but still considered precancerous.

Rate at 30% (High-Grade Dysplasia): If Barrett’s esophagus is present without esophageal stricture but is accompanied by high-grade dysplasia, it is rated at 30%, reflecting the increased risk of progression to cancer and the need for closer monitoring and intervention.

Rate at 10% (Low-Grade Dysplasia): If Barrett’s esophagus is present without esophageal stricture but is associated with low-grade dysplasia, it is rated at 10%, indicating a lower risk compared to high-grade dysplasia but still necessitating ongoing monitoring and management.

Malignancy Development: If cancer (malignancy) develops in Barrett’s esophagus, it is rated separately as malignant neoplasms of the digestive system.

Resolution via Surgery or Other Treatment: If Barrett’s esophagus is resolved through interventions such as surgery or radiofrequency ablation, any residual complications, such as esophageal stricture, are rated according to the appropriate diagnostic code (DC 7203).

DC 7301, Peritoneum, adhesions of, due to surgery, trauma, disease, or infection:

Persistent partial bowel obstruction that is either inoperable and refractory to treatment, or requires total parenteral nutrition (TPN) for obstructive symptoms rate at 80%

Symptomatic peritoneal adhesions, persisting or recurring after surgery, trauma, inflammatory disease process such as chronic cholecystitis or Crohn’s disease, or infection, as determined by a healthcare provider; and clinical evidence of recurrent obstruction requiring hospitalization at least once a year; and medically-directed dietary modification other than total parenteral nutrition (TPN); and at least one of the following: (1) abdominal pain, (2) nausea, (3) vomiting, (4) colic, (5) constipation, or (6) diarrhea rate at 50%

Symptomatic peritoneal adhesions, persisting or recurring after surgery, trauma, inflammatory disease process such as chronic cholecystitis or Crohn’s disease, or infection, as determined by a healthcare provider; and medically-directed dietary modification other than total parenteral nutrition (TPN); and at least one of the following: (1) abdominal pain, (2) nausea, (3) vomiting, (4) colic, (5) constipation, or (6) diarrhea rate at 30%

Symptomatic peritoneal adhesions, persisting or recurring after surgery, trauma, inflammatory disease process such as chronic cholecystitis or Crohn’s disease, or infection, as determined by a healthcare provider, and at least one of the following: (1) abdominal pain, (2) nausea, (3) vomiting, (4) colic, (5) constipation, or (6) diarrhea rate at 10%

History of peritoneal adhesions, currently asymptomatic rate at 0%

Explanation of terms:

Peritoneum: The thin membrane that lines the abdominal cavity and covers the abdominal organs.

Adhesions: Bands of scar-like tissue that form between abdominal tissues and organs, often as a result of surgery, trauma, inflammation, or infection.

Persistent Partial Bowel Obstruction: Incomplete blockage of the bowel that persists over time and is either untreatable with surgery or resistant to treatment or requires total parenteral nutrition (TPN) for relief of obstructive symptoms.

Total Parenteral Nutrition (TPN): A method of feeding that bypasses the digestive system and delivers nutrients directly into the bloodstream.

Symptomatic Peritoneal Adhesions: Adhesions causing symptoms, such as pain or gastrointestinal issues, persisting or recurring after surgery, trauma, inflammatory diseases like chronic cholecystitis or Crohn’s disease, or infection.

Medically-Directed Dietary Modification: Changes in diet prescribed by a healthcare provider to manage symptoms related to peritoneal adhesions, other than TPN.

Abdominal Pain, Nausea, Vomiting, Colic, Constipation, or Diarrhea: Symptoms commonly associated with peritoneal adhesions.

Recurrent Obstruction Requiring Hospitalization: Need for hospitalization due to recurrent episodes of bowel obstruction caused by peritoneal adhesions, occurring at least once a year.

DC 7303, Chronic complications of upper gastrointestinal surgery:

Requiring continuous total parenteral nutrition (TPN) or tube feeding for a period longer than 30 consecutive days in the last six months rate at 80%

Any one of the following symptoms with or without pain: (1) daily vomiting despite oral dietary modification or medication; (2) six or more watery bowel movements per day every day, or explosive bowel movements that are difficult to predict or control; (3) post-prandial (meal-induced) light- headedness (syncope) with sweating and the need for medications to specifically treat complications of upper gastrointestinal surgery such as dumping syndrome or delayed gastric emptying rate at 50%

With two or more of the following symptoms: (1) vomiting two or more times per week or vomiting despite medical treatment; (2) discomfort or pain within an hour of eating and requiring ongoing oral dietary modification; (3) three to five watery bowel movements per day every day rate at 30%

With either nausea or vomiting managed by ongoing medical treatment rate at 10%

Post-operative status, asymptomatic rate at 0%

Note (1): For resection of small intestine, use DC 7328.

Note (2): If pancreatic surgery results in a vitamin or mineral deficiency (e.g., B12, iron, calcium, or fat-soluble vitamins), evaluate under the appropriate vitamin/mineral deficiency code and assign the higher rating. For example, evaluate Vitamin A, B, C or D deficiencies under DC 6313; ocular manifestations of vitamin deficiencies, such as night blindness, under DC 6313; keratitis or keratomalacia due to Vitamin A deficiency under DC 6001; Vitamin E deficiency under neuropathy; and Vitamin K deficiency under prolonged clotting (e.g., DC 7705).

Note (3): This diagnostic code includes operations performed on the esophagus, stomach, pancreas, and small intestine, including bariatric surgery.

Explanation of terms:

Chronic Complications of Upper Gastrointestinal Surgery: Long-term issues arising from surgical procedures on the upper gastrointestinal tract, including the esophagus, stomach, pancreas, and small intestine.

Total Parenteral Nutrition (TPN): A method of feeding that bypasses the digestive system and delivers nutrients directly into the bloodstream.

Tube Feeding: Providing nutrients directly into the stomach or intestines through a tube, bypassing the mouth and esophagus.

Dumping Syndrome: A group of symptoms, such as nausea, vomiting, diarrhea, and dizziness, occurring after eating, particularly after gastric surgery.

Delayed Gastric Emptying: A condition where the stomach takes longer than usual to empty its contents into the small intestine, leading to symptoms like nausea, vomiting, and bloating.

Syncope: Temporary loss of consciousness, often referred to as fainting.

Watery Bowel Movements: Loose stools that are predominantly liquid in consistency.

Post-prandial: Referring to the period after eating a meal.

Vitamin or Mineral Deficiency: Inadequate levels of essential vitamins or minerals in the body, which can result from malabsorption after gastrointestinal surgery.

Resection of Small Intestine: Surgical removal of a portion of the small intestine.

Oral Dietary Modification: Adjustments made to the diet, such as avoiding certain foods or eating smaller, more frequent meals, to manage symptoms.

Requiring Ongoing Medical Treatment: Symptoms that persist despite interventions and necessitate continuous medical management.

Post-operative Status: Referring to the condition of the patient after undergoing surgery.

DC 7304, Peptic ulcer disease:

Post-operative for perforation or hemorrhage, for three months rate at 100%

Continuous abdominal pain with intermittent vomiting, recurrent hematemesis (vomiting blood) or melena (tarry stools); and manifestations of anemia which require hospitalization at least once in the past 12 months rate at 60%

Episodes of abdominal pain, nausea, or vomiting, that: last for at least three consecutive days in duration; occur four or more times in the past 12 months; and are managed by daily prescribed medication rate at 40%

Episodes of abdominal pain, nausea, or vomiting, that: last for at least three consecutive days in duration; occur three times or less in the past 12 months; and are managed by daily prescribed medication rate at 20%

History of peptic ulcer disease documented by endoscopy or diagnostic imaging studies rate at 0%

Note: After three months at the 100% evaluation, rate on residuals as determined by mandatory VA medical examination. Apply the provisions of § 3.105(e) of this chapter to any change in evaluation based upon that or any subsequent examination.

Explanation of terms:

Peptic Ulcer Disease: A condition characterized by open sores (ulcers) that develop on the inner lining of the stomach, upper small intestine, or esophagus, often caused by infection with Helicobacter pylori bacteria or prolonged use of nonsteroidal anti-inflammatory drugs (NSAIDs).

Post-operative for Perforation or Hemorrhage: Refers to the period following surgery to repair a peptic ulcer that has perforated (developed a hole) or hemorrhaged (bleeding).

Continuous Abdominal Pain with Intermittent Vomiting: Persistent pain in the abdomen accompanied by occasional episodes of vomiting.

Recurrent Hematemesis: Repeated episodes of vomiting blood, indicating ongoing bleeding from the ulcer.

Melena: Passage of dark, tarry stools due to the presence of digested blood in the stool.

Manifestations of Anemia: Symptoms related to low red blood cell count, such as fatigue, weakness, and pallor.

Hospitalization: Requires admission to the hospital for treatment and management of symptoms.

Episodes of Abdominal Pain, Nausea, or Vomiting: Periods of discomfort or gastrointestinal symptoms.

Last for at Least Three Consecutive Days: Symptoms persist for a minimum of three days in a row.

Occur Four or More Times in the Past 12 Months: Repeated occurrences of symptoms within a one-year period.

Managed by Daily Prescribed Medication: Requires ongoing treatment with medications to alleviate symptoms.

DC 7307, Gastritis, chronic:

Rate as peptic ulcer disease (DC 7304).

Note: This diagnostic code includes Helicobacter pylori infection, drug- induced gastritis, Zollinger-Ellison syndrome, and portal-hypertensive gastropathy with varix-related complications.

Explanation of terms:

Gastritis: Inflammation of the lining of the stomach, which can be acute (short-term) or chronic (long-term). Chronic gastritis involves persistent inflammation and damage to the stomach lining over time.

Rate as Peptic Ulcer Disease (DC 7304): Chronic gastritis is rated similarly to peptic ulcer disease because both conditions involve ongoing inflammation and damage to the stomach lining, leading to similar symptoms and complications.

Helicobacter pylori Infection: A bacterial infection of the stomach lining that can cause chronic gastritis and increase the risk of developing peptic ulcers.

Drug-induced Gastritis: Inflammation of the stomach lining caused by prolonged use of certain medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs) or corticosteroids.

Zollinger-Ellison Syndrome: A rare condition characterized by the formation of tumors (gastrinomas) in the pancreas or duodenum, leading to excessive production of stomach acid and chronic gastritis.

Portal-Hypertensive Gastropathy with Varix-Related Complications: Gastritis caused by increased pressure in the portal vein (portal hypertension), often due to liver cirrhosis or other liver diseases, leading to the development of dilated blood vessels (varices) in the stomach lining and related complications such as bleeding.

DC 7308, Postgastrectomy syndrome:

Rate residuals as chronic complications of upper gastrointestinal surgery (DC 7303).

Explanation of terms:

Postgastrectomy Syndrome: Postgastrectomy syndrome refers to a collection of symptoms and complications that arise after surgical removal (gastrectomy) of part or all of the stomach. This syndrome can occur following various types of gastric surgeries, including partial gastrectomy (removal of a portion of the stomach) or total gastrectomy (complete removal of the stomach). Postgastrectomy syndrome encompasses a range of gastrointestinal symptoms, such as changes in eating habits, early satiety (feeling full quickly after eating), weight loss, and digestive issues like diarrhea or bloating.

Rate Residuals as Chronic Complications of Upper Gastrointestinal Surgery (DC 7303): This instruction indicates how to evaluate and rate the severity of postgastrectomy syndrome for disability compensation purposes. The residuals, or lasting effects, of postgastrectomy syndrome are assessed and rated under the diagnostic code (DC) 7303, which covers chronic complications arising from upper gastrointestinal surgery. This code encompasses a variety of long-term issues resulting from surgeries involving the upper gastrointestinal tract, including the stomach and esophagus. By rating postgastrectomy syndrome as a chronic complication of upper gastrointestinal surgery, it ensures that the condition is properly accounted for in determining disability benefits for affected individuals.

DC 7309, Stomach, stenosis of:

Rate as chronic complications of upper gastrointestinal surgery (DC 7303) or peptic ulcer disease (DC 7304), depending on the predominant disability.

Explanation of terms:

Stomach Stenosis: Stomach stenosis refers to the narrowing or constriction of the stomach’s opening or passage. This narrowing can occur due to various reasons, including scarring from ulcers, inflammation, or surgical procedures involving the stomach. Stomach stenosis can lead to symptoms such as difficulty swallowing, nausea, vomiting, abdominal pain, and feeling full quickly after eating.

Rate as Chronic Complications of Upper Gastrointestinal Surgery (DC 7303) or Peptic Ulcer Disease (DC 7304), Depending on the Predominant Disability: This instruction guides how to evaluate and rate the severity of stomach stenosis for disability compensation purposes. The rating depends on which condition predominantly contributes to the disability experienced by the individual.

Chronic Complications of Upper Gastrointestinal Surgery (DC 7303): If stomach stenosis is primarily a consequence of prior upper gastrointestinal surgery, such as gastrectomy or procedures involving the stomach, it should be rated under this diagnostic code. DC 7303 covers chronic complications arising from surgeries involving the upper gastrointestinal tract.

Peptic Ulcer Disease (DC 7304): If stomach stenosis is mainly a result of peptic ulcer disease, which involves ulcers in the stomach lining or upper part of the small intestine, it should be rated under this diagnostic code. DC 7304 covers various complications arising from peptic ulcer disease, such as perforation, hemorrhage, or chronic symptoms like abdominal pain and vomiting.

The choice between these two diagnostic codes depends on the underlying cause and predominant disability associated with stomach stenosis in each individual case.

DC 7310, Stomach, injury of, residuals:

Pre-operative: Rate as adhesions of peritoneum due to surgery, trauma, disease, or infection (DC 7301). No adhesions are necessary when evaluating under DC 7301.

Post-operative: Rate as chronic complications of upper gastrointestinal surgery (DC 7303).

Explanation of terms:

Stomach Injury Residuals: This refers to lasting effects or consequences resulting from an injury to the stomach, either before or after surgical intervention.

Pre-operative: This refers to the period before surgery. If the stomach injury occurred before any surgical intervention, the residuals or lasting effects of the injury should be evaluated and rated as per the guidelines provided under the diagnostic code DC 7301, which covers adhesions of the peritoneum due to various causes such as surgery, trauma, disease, or infection. Adhesions are fibrous bands of scar tissue that can form between abdominal organs or tissues, leading to complications like bowel obstruction or chronic abdominal pain.

Rate as Adhesions of Peritoneum due to Surgery, Trauma, Disease, or Infection (DC 7301): If the stomach injury occurred before surgery, the resulting residuals should be rated under this diagnostic code. The severity of any adhesions present would determine the disability rating.

Post-operative: This refers to the period after surgery. If the stomach injury occurred as a result of surgical intervention or if there are complications arising from the surgery, the residuals or lasting effects should be evaluated and rated as per the guidelines provided under the diagnostic code DC 7303.

Rate as Chronic Complications of Upper Gastrointestinal Surgery (DC 7303): If the stomach injury occurred as a result of upper gastrointestinal surgery or if there are complications related to the surgery, such as chronic symptoms or functional impairments, the residuals should be rated under this diagnostic code.

To summarize, depending on whether the stomach injury occurred before or after surgery, the appropriate diagnostic code is used to evaluate and rate the residuals or lasting effects of the injury.

DC 7312, Cirrhosis of the liver:

Liver disease with Model for End-Stage Liver Disease score greater than or equal to 15; or with continuous daily debilitating symptoms, generalized weakness and at least one of the following: (1) ascites (fluid in the abdomen), or (2) a history of spontaneous bacterial peritonitis, or (3) hepatic encephalopathy, or (4) variceal hemorrhage, or (5) coagulopathy, or (6) portal gastropathy, or (7) hepatopulmonary or hepatorenal syndrome rate at 100%

Liver disease with Model for End-Stage Liver Disease score greater than 11 but less than 15; or with daily fatigue and at least one episode in the last year of either (1) variceal hemorrhage, or (2) portal gastropathy or hepatic encephalopathy rate at 60%

Liver disease with Model for End-Stage Liver Disease score of 10 or 11; or with signs of portal hypertension such as splenomegaly or ascites (fluid in the abdomen) and either weakness, anorexia, abdominal pain, or malaise rate at 30%

Liver disease with Model for End-Stage Liver Disease score greater than 6 but less than 10; or with evidence of either anorexia, weakness, abdominal pain or malaise rate at 10%

Asymptomatic, but with a history of liver disease rate at 0%

Note (1): Rate hepatocellular carcinoma occurring with cirrhosis under DC 7343 (Malignant neoplasms of the digestive system, exclusive of skin growths) in lieu of DC 7312.

Note (2): Biochemical studies, imaging studies, or biopsy must confirm liver dysfunction (including hyponatremia, thrombocytopenia, and/or coagulopathy).

Note (3): Rate condition based on symptomatology where the evidence does not contain a Model for End-Stage Liver Disease score.

Explanation of terms:

Cirrhosis of the Liver: This is a chronic liver disease characterized by scarring and damage to the liver tissue, which can impair liver function over time.

Liver Disease with Model for End-Stage Liver Disease (MELD) Score Greater Than or Equal to 15: MELD is a scoring system used to predict the prognosis of patients with chronic liver disease. A score of 15 or higher indicates severe liver dysfunction. If a veteran has liver disease with a MELD score of 15 or higher or experiences continuous debilitating symptoms along with specific complications like ascites (abdominal fluid accumulation), spontaneous bacterial peritonitis, hepatic encephalopathy (brain dysfunction due to liver failure), variceal hemorrhage (bleeding from enlarged veins in the esophagus or stomach), coagulopathy (bleeding disorder), portal gastropathy, or hepatopulmonary or hepatorenal syndrome, they are rated at 100%.

Liver Disease with MELD Score Greater Than 11 but Less Than 15: If the MELD score falls between 11 and 14, or if the veteran experiences daily fatigue and at least one episode in the last year of either variceal hemorrhage or portal gastropathy or hepatic encephalopathy, they are rated at 60%.

Liver Disease with MELD Score of 10 or 11: If the MELD score is between 10 and 11, or if there are signs of portal hypertension such as splenomegaly (enlarged spleen) or ascites along with symptoms like weakness, anorexia (loss of appetite), abdominal pain, or malaise, the rating is at 30%.

Liver Disease with MELD Score Greater Than 6 but Less Than 10: If the MELD score is between 7 and 9, or if there is evidence of symptoms like anorexia, weakness, abdominal pain, or malaise, the rating is at 10%.

Asymptomatic with a History of Liver Disease: If the veteran is asymptomatic but has a documented history of liver disease, the rating is at 0%.

Notes:

If hepatocellular carcinoma (liver cancer) occurs with cirrhosis, it is rated under a different diagnostic code.

Confirmation of liver dysfunction through biochemical studies, imaging studies, or biopsy is necessary.

If there’s no MELD score available, the condition is rated based on symptomatology.

DC 7314, Chronic biliary tract disease:

With three or more clinically documented attacks of right upper quadrant pain with nausea and vomiting during the past 12 months; or requiring dilatation of biliary tract strictures at least once during the past 12 months rate at 30%

With one or two clinically documented attacks of right upper quadrant pain with nausea and vomiting in the past 12 months rate at 10%

Asymptomatic, without history of a clinically documented attack of right upper quadrant pain with nausea and vomiting in the past 12 months rate at 0%

Note: This diagnostic code includes cholangitis, biliary strictures, Sphincter of Oddi dysfunction, bile duct injury, and choledochal cyst. Rate primary sclerosing cholangitis under chronic liver disease without cirrhosis (DC 7345).

Explanation of terms:

Chronic Biliary Tract Disease: This refers to long-standing conditions affecting the bile ducts, which are tubes that carry bile from the liver and gallbladder to the small intestine.

With Three or More Clinically Documented Attacks of Right Upper Quadrant (RUQ) Pain with Nausea and Vomiting During the Past 12 Months: If the individual has experienced three or more episodes of pain in the upper right side of the abdomen along with nausea and vomiting within the last year, or if they’ve required dilation of strictures (narrowed areas) in the bile ducts at least once in the past year, they are rated at 30%.

With One or Two Clinically Documented Attacks of RUQ Pain with Nausea and Vomiting in the Past 12 Months: If the individual has had one or two documented episodes of RUQ pain with associated nausea and vomiting in the past year, the rating is at 10%.

Asymptomatic, Without History of Clinically Documented Attacks of RUQ Pain with Nausea and Vomiting in the Past 12 Months: If the individual is currently symptom-free and hasn’t experienced documented episodes of RUQ pain with nausea and vomiting in the past year, the rating is at 0%.

Note: This diagnostic code encompasses various conditions such as cholangitis (inflammation of the bile ducts), biliary strictures (narrowing of the bile ducts), Sphincter of Oddi dysfunction (malfunction of the valve that controls bile flow into the small intestine), bile duct injury, and choledochal cysts (cysts in the bile ducts). Primary sclerosing cholangitis is rated under a different diagnostic code.

DC 7315, Cholelithiasis, chronic:

Rate as chronic biliary tract disease (DC 7314).

Explanation of terms:

Cholelithiasis, Chronic: This refers to the presence of gallstones (solid particles that form in the gallbladder) over a prolonged period.

Rate as Chronic Biliary Tract Disease (DC 7314): Chronic cholelithiasis, which involves long-standing gallstone formation, is rated under the same category as chronic biliary tract disease (DC 7314). This means that the severity and impact of chronic cholelithiasis on the biliary tract are evaluated similarly to other chronic conditions affecting the bile ducts, such as cholangitis, biliary strictures, and bile duct injuries.

In essence, the rating for chronic cholelithiasis is determined based on the criteria outlined in DC 7314 for chronic biliary tract disease.

DC 7317, Gallbladder, injury of:

Rate as adhesions of the peritoneum due to surgery, trauma, disease, or infection (DC 7301); or chronic gallbladder and biliary tract disease (DC 7314), or cholecystectomy (gallbladder removal), complications of (such as strictures and biliary leaks) (DC 7318), depending on the predominant disability.

Note: When rating gallbladder injuries analogous to DC 7301, a finding of adhesions is not necessary.

Explanation of terms:

Gallbladder injury refers to damage or trauma to the gallbladder, which is a small organ located beneath the liver that stores bile produced by the liver.

Rate as adhesions of the peritoneum due to surgery, trauma, disease, or infection (DC 7301): This means that if the injury to the gallbladder results in adhesions (bands of scar tissue) forming in the peritoneum (the membrane lining the abdominal cavity), it should be rated according to the disability criteria outlined in DC 7301. Adhesions can occur as a result of various causes such as surgery, trauma, disease, or infection.

Chronic gallbladder and biliary tract disease (DC 7314): If the injury leads to chronic issues involving the gallbladder or biliary tract (the ducts that transport bile from the liver to the small intestine), it should be rated based on the disability criteria specified in DC 7314. This could include conditions like chronic cholecystitis (inflammation of the gallbladder) or cholelithiasis (the presence of gallstones).

Cholecystectomy (gallbladder removal), complications of (such as strictures and biliary leaks) (DC 7318): If the injury results from complications arising from a previous cholecystectomy (surgical removal of the gallbladder), such as the development of strictures (narrowing) or biliary leaks, it should be rated based on the disability criteria outlined in DC 7318.

DC 7317 provides guidance on how to rate disabilities resulting from injuries to the gallbladder, depending on the specific circumstances and predominant disability present.

DC 7318, Cholecystectomy (gallbladder removal), complications of (such as strictures and biliary leaks):

With recurrent abdominal pain (post-prandial or nocturnal); and chronic diarrhea characterized by three or more watery bowel movements per day rate at 30%

With intermittent abdominal pain; and diarrhea characterized by one to two watery bowel movements per day rate at 10%

Asymptomatic rate at 0%

Explanation of terms:

Cholecystectomy (gallbladder removal), complications of (such as strictures and biliary leaks): This refers to complications that can arise as a result of undergoing a cholecystectomy, which is the surgical removal of the gallbladder.

With recurrent abdominal pain (post-prandial or nocturnal); and chronic diarrhea characterized by three or more watery bowel movements per day rate at 30%: If the individual experiences recurring abdominal pain after eating (post-prandial) or during the night (nocturnal), along with chronic diarrhea involving three or more watery bowel movements per day, they are eligible for a disability rating of 30%.

With intermittent abdominal pain; and diarrhea characterized by one to two watery bowel movements per day rate at 10%: If the individual experiences occasional abdominal pain and diarrhea involving one to two watery bowel movements per day, they qualify for a disability rating of 10%.

Asymptomatic rate at 0%: If the individual is not experiencing any symptoms related to the complications of cholecystectomy, they are assigned a disability rating of 0%.

DC 7318 provides guidelines for assigning disability ratings based on the symptoms experienced by individuals who have undergone a cholecystectomy and are experiencing complications such as recurrent abdominal pain and diarrhea. The severity of the symptoms determines the disability rating assigned.

DC 7319, Irritable bowel syndrome (IBS):

Abdominal pain related to defecation at least one day per week during the previous three months; and two or more of the following: (1) change in stool frequency, (2) change in stool form, (3) altered stool passage (straining and/or urgency), (4) mucorrhea, (5) abdominal bloating, or (6) subjective distension rate at 30%

Abdominal pain related to defecation for at least three days per month during the previous three months; and two or more of the following: (1) change in stool frequency, (2) change in stool form, (3) altered stool passage (straining and/or urgency), (4) mucorrhea, (5) abdominal bloating, or (6) subjective distension rate at 20%

Abdominal pain related to defecation at least once during the previous three months; and two or more of the following: (1) change in stool frequency, (2) change in stool form, (3) altered stool passage (straining and/or urgency), (4) mucorrhea, (5) abdominal bloating, or (6) subjective distension rate at 10%

Note: This diagnostic code may include functional digestive disorders (see § 3.317 of this chapter), such as dyspepsia, functional bloating and constipation, and diarrhea. Evaluate other symptoms of a functional digestive disorder not encompassed by this diagnostic code under the appropriate diagnostic code, to include gastrointestinal dysmotility syndrome (DC 7356), following the general principles of § 4.14 and this section.

Explanation of terms:

Irritable bowel syndrome (IBS): This is a gastrointestinal disorder characterized by abdominal pain or discomfort and changes in bowel habits.

Abdominal pain related to defecation at least one day per week during the previous three months; and two or more of the following: This criteria specifies that the individual must experience abdominal pain associated with bowel movements for at least one day per week over the past three months. Additionally, they must have experienced two or more of the following symptoms: a change in stool frequency, a change in stool form, altered stool passage (straining and/or urgency), mucorrhea (mucus in the stool), abdominal bloating, or subjective distension (feeling of abdominal fullness). This combination of symptoms warrants a disability rating of 30%.

Abdominal pain related to defecation for at least three days per month during the previous three months; and two or more of the following: In this scenario, the individual experiences abdominal pain associated with bowel movements for at least three days per month over the past three months, along with two or more additional symptoms listed above. This constellation of symptoms qualifies for a disability rating of 20%.

Abdominal pain related to defecation at least once during the previous three months; and two or more of the following: Here, the individual experiences abdominal pain related to bowel movements at least once during the previous three months, along with two or more additional symptoms listed above. This pattern of symptoms merits a disability rating of 10%.

DC 7319 outlines the criteria for diagnosing and rating Irritable Bowel Syndrome (IBS) based on the frequency and severity of symptoms experienced by the individual. The rating varies depending on the frequency of abdominal pain related to defecation and the presence of additional symptoms associated with bowel habits.

DC 7323, Colitis, ulcerative:

Rate as Crohn’s disease or undifferentiated form of inflammatory bowel disease (DC 7326).

Explanation of terms:

Colitis, ulcerative: This refers to a type of inflammatory bowel disease characterized by inflammation and ulcers in the lining of the colon and rectum. It typically involves symptoms such as abdominal pain, diarrhea, rectal bleeding, and urgency to have bowel movements.

Rate as Crohn’s disease or undifferentiated form of inflammatory bowel disease (DC 7326): This instruction indicates that cases of colitis, ulcerative should be evaluated and rated under the diagnostic code (DC) 7326, which covers Crohn’s disease or an undifferentiated form of inflammatory bowel disease. Crohn’s disease is another type of inflammatory bowel disease that can affect any part of the gastrointestinal tract, while an undifferentiated form of inflammatory bowel disease refers to cases that do not clearly fit the criteria for either ulcerative colitis or Crohn’s disease.

DC 7323 directs that cases of colitis, ulcerative should be rated under the diagnostic code for Crohn’s disease or an undifferentiated form of inflammatory bowel disease, rather than having a separate rating code specifically for ulcerative colitis.

DC 7325, Enteritis, chronic:

Rate as Irritable Bowel Syndrome (DC 7319) or Crohn’s disease or undifferentiated form of inflammatory bowel disease (DC 7326), depending on the predominant disability.

Explanation of terms:

Enteritis, chronic: Enteritis refers to inflammation of the small intestine. Chronic enteritis

indicates long-lasting or recurring inflammation of the small intestine, which can lead to symptoms such as abdominal pain, diarrhea, nausea, and weight loss.

Rate as Irritable Bowel Syndrome (DC 7319) or Crohn’s disease or undifferentiated form of inflammatory bowel disease (DC 7326), depending on the predominant disability: This instruction indicates how cases of chronic enteritis should be evaluated and rated.

Irritable Bowel Syndrome (IBS): This is a functional gastrointestinal disorder characterized by abdominal pain or discomfort along with changes in bowel habits, without any evidence of underlying damage or inflammation in the digestive tract. If the predominant disability of the chronic enteritis is consistent with the symptoms and criteria for IBS, it should be rated under the diagnostic code for IBS (DC 7319).

Crohn’s disease or undifferentiated form of inflammatory bowel disease: Crohn’s disease is a type of inflammatory bowel disease that can affect any part of the gastrointestinal tract, leading to inflammation, ulcers, and other complications. If the predominant disability of the chronic enteritis aligns with the symptoms and characteristics of Crohn’s disease or an undifferentiated form of inflammatory bowel disease, it should be rated under the diagnostic code for these conditions (DC 7326).

In summary, DC 7325 directs that cases of chronic enteritis should be rated either as Irritable Bowel Syndrome or as Crohn’s disease/undifferentiated form of inflammatory bowel disease, depending on the nature and severity of the symptoms and disability observed in the individual case.

DC 7326, Crohn’s disease or undifferentiated form of inflammatory bowel disease:

Severe inflammatory bowel disease that is unresponsive to treatment; and requires hospitalization at least once per year; and results in either an inability to work or is characterized by recurrent abdominal pain associated with at least two of the following: (1) six or more episodes per day of diarrhea, (2) six or more episodes per day of rectal bleeding, (3) recurrent episodes of rectal incontinence, or (4) recurrent abdominal distension rate at 100%

Moderate inflammatory bowel disease that is managed on an outpatient basis with immunosuppressants or other biologic agents; and is characterized by recurrent abdominal pain, four to five daily episodes of diarrhea; and intermittent signs of toxicity such as fever, tachycardia, or anemia rate at 60%

Mild to moderate inflammatory bowel disease that is managed with oral and topical agents (other than immunosuppressants or other biologic agents); and is characterized by recurrent abdominal pain with three or less daily episodes of diarrhea and minimal signs of toxicity such as fever, tachycardia, or anemia rate at 30%

Minimal to mild symptomatic inflammatory bowel disease that is managed with oral or topical agents (other than immunosuppressants or other biologic agents); and is characterized by recurrent abdominal pain with three or less daily episodes of diarrhea and no signs of systemic toxicity rate at 10%

Note (1): Following colectomy/colostomy with persistent or recurrent symptoms, rate either under DC 7326 or DC 7329 (Intestine, large, resection of), whichever provides the highest rating.

Note (2): VA requires diagnoses under DC 7326 to be confirmed by endoscopy or radiologic studies.

Note (3): Inflammation may involve small bowel (ileitis), large bowel (colitis), or inflammation of any component of the gastrointestinal tract from the mouth to the anus.

Explanation of terms:

Crohn’s disease is a chronic inflammatory condition that primarily affects the gastrointestinal tract, although it can involve any part of the digestive system from the mouth to the anus. It is classified as an inflammatory bowel disease (IBD), along with ulcerative colitis, another similar condition.

Severe inflammatory bowel disease: This rating applies to cases that are unresponsive to treatment and require hospitalization at least once a year. It results in an inability to work or recurrent abdominal pain associated with at least two of the following: frequent diarrhea, rectal bleeding, rectal incontinence, or abdominal distension. The disability rating for this level of severity is 100%.

Moderate inflammatory bowel disease: This rating is for cases managed on an outpatient basis with immunosuppressants or other biologic agents. Symptoms include recurrent abdominal pain, four to five daily episodes of diarrhea, and intermittent signs of toxicity like fever, rapid heart rate, or anemia. The disability rating for this level of severity is 60%.

Mild to moderate inflammatory bowel disease: This rating applies when the disease is managed with oral and topical medications (excluding immunosuppressants or biologic agents). Symptoms include recurrent abdominal pain with fewer daily episodes of diarrhea and minimal signs of toxicity. The disability rating for this level of severity is 30%.

Minimal to mild symptomatic inflammatory bowel disease: This rating is for relatively mild cases managed with oral or topical medications other than immunosuppressants or biologic agents. Symptoms include occasional abdominal pain and few daily episodes of diarrhea with no signs of systemic toxicity. The disability rating for this level of severity is 10%.

It’s important to note that diagnoses under DC 7326 must be confirmed by endoscopy or radiologic studies. Additionally, inflammation can affect any part of the gastrointestinal tract from the mouth to the anus. After colectomy or colostomy with persistent or recurrent symptoms, the rating is determined based on whichever code provides the highest rating, either DC 7326 or DC 7329 (Intestine, large, resection of).

DC 7327, Diverticulitis and diverticulosis:

Diverticular disease requiring hospitalization for abdominal distress, fever, and leukocytosis (elevated white blood cells) one or more times in the past 12 months; and with at least one of the following complications: (1) hemorrhage, (2) obstruction, (3) abscess, (4) peritonitis, or (5) perforation rate at 30%

Diverticular disease requiring hospitalization for abdominal distress, fever, and leukocytosis (elevated white blood cells) one or more times in the past 12 months; and without associated (1) hemorrhage, (2) obstruction, (3) abscess, (4) peritonitis, or (5) perforation rate at 20%

Asymptomatic; or a symptomatic diverticulitis or diverticulosis that is managed by diet and medication rate at 0%

Note: For colectomy or colostomy, use DC 7327 or DC 7329 (Intestine, large, resection of), whichever results in a higher evaluation.

Explanation of terms:

Diverticulitis and diverticulosis are conditions that involve the formation of small pouches (diverticula) in the wall of the colon (large intestine). Diverticulosis refers to the presence of these pouches without inflammation or other complications, while diverticulitis occurs when these pouches become inflamed or infected.

Here’s an explanation of the medical terms in DC 7327:

Diverticular disease requiring hospitalization for abdominal distress, fever, and leukocytosis (elevated white blood cells) one or more times in the past 12 months; and with at least one of the following complications: (1) hemorrhage, (2) obstruction, (3) abscess, (4) peritonitis, or (5) perforation rate at 30%: This refers to cases of diverticulitis that have led to hospitalization due to symptoms such as abdominal pain, fever, and increased white blood cell count. Additionally, the condition is complicated by issues like bleeding, obstruction (blockage of the intestine), abscess formation, peritonitis (inflammation of the abdominal lining), or perforation (tearing) of the intestine. This severity level is rated at 30%.

Diverticular disease requiring hospitalization for abdominal distress, fever, and leukocytosis (elevated white blood cells) one or more times in the past 12 months; and without associated (1) hemorrhage, (2) obstruction, (3) abscess, (4) peritonitis, or (5) perforation rate at 20%: Similar to the previous category, but without the mentioned complications, resulting in a lower severity level rated at 20%.

Asymptomatic; or a symptomatic diverticulitis or diverticulosis that is managed by diet and medication rate at 0%: Refers to cases where there are no symptoms or where symptoms are manageable with dietary changes and medications. This category receives a 0% rating in terms of severity.

DC 7328, Intestine, small, resection of:

Status post intestinal resection with undernutrition and anemia; and requiring total parenteral nutrition (TPN) rate at 80%

Status post intestinal resection with undernutrition and anemia; and requiring prescribed oral dietary supplementation, continuous medication and intermittent total parenteral nutrition (TPN) rate at 60%

Status post intestinal resection with four or more episodes of diarrhea per day resulting in undernutrition and anemia; and requiring prescribed oral dietary supplementation and continuous medication rate at 40%

Status post intestinal resection with four or more episodes of diarrhea per day rate at 20%

Status post intestinal resection, asymptomatic rate at 0%

Note: This diagnostic code includes short bowel syndrome, mesenteric ischemic thrombosis, and post-bariatric surgery complications. Where short bowel syndrome results in high-output syndrome, to include high-output stoma, consider assigning a higher evaluation under DC 7329 (Intestine, large, resection of).

Explanation of terms:

Status post intestinal resection with undernutrition and anemia; and requiring total parenteral nutrition (TPN) rate at 80%: This refers to individuals who have undergone surgery to remove a portion of their small intestine and subsequently experience undernutrition (malnutrition) and anemia (low red blood cell count), necessitating the use of total parenteral nutrition (TPN) to meet their nutritional needs. This severity level is rated at 80%.

Status post intestinal resection with undernutrition and anemia; and requiring prescribed oral dietary supplementation, continuous medication, and intermittent total parenteral nutrition (TPN) rate at 60%: Similar to the previous category, but in addition to TPN, individuals also require prescribed oral dietary supplements and continuous medication. This severity level is rated at 60%.

Status post intestinal resection with four or more episodes of diarrhea per day resulting in undernutrition and anemia; and requiring prescribed oral dietary supplementation and continuous medication rate at 40%: This category applies to individuals who experience frequent diarrhea (four or more episodes per day) following intestinal resection, leading to undernutrition and anemia, and necessitating dietary supplements and continuous medication. This severity level is rated at 40%.

Status post intestinal resection with four or more episodes of diarrhea per day rate at 20%: Refers to individuals who experience frequent diarrhea (four or more episodes per day) after intestinal resection, without severe undernutrition or anemia. This severity level is rated at 20%.

Status post intestinal resection, asymptomatic rate at 0%: For individuals who have undergone intestinal resection surgery but do not experience any symptoms related to the procedure. This category receives a 0% rating in terms of severity.

DC 7329, Intestine, large, resection of:

Total colectomy with formation of ileostomy, high-output syndrome, and more than two episodes of dehydration requiring intravenous hydration in the past 12 months rate at 100%

Total colectomy with or without permanent colostomy or ileostomy without high-output syndrome rate at 60%

Partial colectomy with permanent colostomy or ileostomy without high-output syndrome rate at 40%

Partial colectomy with reanastomosis (reconnection of the intestinal tube) with loss of ileocecal valve and recurrent episodes of diarrhea more than 3 times per day rate at 20%

Partial colectomy with reanastomosis (reconnection of the intestinal tube) rate at 10%

Explanation of terms:

Total colectomy with formation of ileostomy, high-output syndrome, and more than two episodes of dehydration requiring intravenous hydration in the past 12 months rate at 100%: This refers to the surgical removal of the entire large intestine (colon) with the creation of an ileostomy (an opening in the abdominal wall through which the small intestine is diverted to drain into a pouch on the outside of the body). High-output syndrome is a condition where the ileostomy produces excessive amounts of watery stool, leading to dehydration. If there have been more than two episodes of dehydration requiring intravenous hydration in the past year, it is rated at 100%.

Total colectomy with or without permanent colostomy or ileostomy without high-output syndrome rate at 60%: In cases where a total colectomy (removal of the entire colon) has been performed, with or without the creation of a permanent colostomy or ileostomy, and there is no high-output syndrome, it is rated at 60%.

Partial colectomy with permanent colostomy or ileostomy without high-output syndrome rate at 40%: If only a portion of the colon is removed (partial colectomy), with the creation of a permanent colostomy or ileostomy but without high-output syndrome, it is rated at 40%.

Partial colectomy with reanastomosis (reconnection of the intestinal tube) with loss of ileocecal valve and recurrent episodes of diarrhea more than 3 times per day rate at 20%: In cases where only a portion of the colon is removed and the remaining parts are surgically reconnected (reanastomosis), but there is loss of the ileocecal valve (a valve that separates the small and large intestines), resulting in recurrent episodes of diarrhea more than three times per day, it is rated at 20%.

Partial colectomy with reanastomosis (reconnection of the intestinal tube) rate at 10%: Similar to the previous category, but without the loss of the ileocecal valve and with less severe diarrhea, it is rated at 10%.

DC 7330, Intestinal fistulous disease, external:

Requiring total parenteral nutrition (TPN); or enteral nutritional support along with at least one of the following: (1) daily discharge equivalent to four or more ostomy bags (sized 130 cc), (2) requiring ten or more pad changes per day, or (3) a Body Mass Index (BMI) less than 16 and persistent drainage (any amount) for more than 1 month during the past 12 months rate at 100%

Requiring enteral nutritional support along with at least one of the following: (1) daily discharge equivalent to three or less ostomy bags (sized 130 cc), (2) requiring fewer than ten pad changes per day, or (3) a Body Mass Index (BMI) of 16 to 18 inclusive and persistent drainage (any amount) for more than 2 months in the past 12 months rate at 60%

Intermittent fecal discharge with persistent drainage for more than 3 months in the past 12 months rate at 30%

Note: This code applies to external fistulas that have developed as a consequence of abdominal trauma, surgery, radiation, malignancy, infection, or ischemia.

Explanation of terms:

Intestinal fistulous disease, external: This refers to a condition where abnormal passageways (fistulas) develop between the intestine and the skin surface, resulting in the leakage of intestinal contents outside the body.

Requiring total parenteral nutrition (TPN); or enteral nutritional support along with at least one of the following: (1) daily discharge equivalent to four or more ostomy bags (sized 130 cc), (2) requiring ten or more pad changes per day, or (3) a Body Mass Index (BMI) less than 16 and persistent drainage (any amount) for more than 1 month during the past 12 months rate at 100%: This category describes severe cases where the patient requires total parenteral nutrition (nutrition delivered directly into the bloodstream) or enteral nutritional support (nutrition delivered into the gastrointestinal tract) due to the fistula. Additionally, specific criteria such as the volume of discharge or the need for frequent pad changes are mentioned, along with a low BMI and persistent drainage for more than one month in the past year, resulting in a 100% disability rating.

Requiring enteral nutritional support along with at least one of the following: (1) daily discharge equivalent to three or less ostomy bags (sized 130 cc), (2) requiring fewer than ten pad changes per day, or (3) a Body Mass Index (BMI) of 16 to 18 inclusive and persistent drainage (any amount) for more than 2 months in the past 12 months rate at 60%: This category describes cases where the patient still requires enteral nutritional support, but with less severe criteria compared to the 100% rating. It includes specific requirements for discharge volume, pad changes, BMI range, and persistent drainage for more than two months in the past year, resulting in a 60% disability rating.

Intermittent fecal discharge with persistent drainage for more than 3 months in the past 12 months rate at 30%: This category describes cases where there is intermittent discharge of feces through the fistula, along with persistent drainage for more than three months in the past year, resulting in a 30% disability rating.

DC 7332, Rectum and anus, impairment of sphincter control:

Complete loss of sphincter control characterized by incontinence or retention that is not responsive to a physician-prescribed bowel program and requires either surgery or digital stimulation, medication (beyond laxative use), and special diet; or incontinence to solids and/or liquids two or more times per day, which requires changing a pad two or more times per day rate at 100%

Complete or partial loss of sphincter control characterized by incontinence or retention that is partially responsive to a physician-prescribed bowel program and requires either surgery or digital stimulation, medication (beyond laxative use), and special diet; or incontinence to solids and/or liquids two or more times per week, which requires wearing a pad two or more times per week rate at 60%

Complete or partial loss of sphincter control characterized by incontinence or retention that is fully responsive to a physician-prescribed bowel program and requires digital stimulation, medication (beyond laxative use), and special diet; or incontinence to solids and/or liquids two or more times per month, which requires wearing a pad two or more times per month rate at 30%

Complete or partial loss of sphincter control characterized by incontinence or retention that is fully responsive to a physician-prescribed bowel program and requires medication or special diet; or incontinence to solids and/or liquids at least once every six months, which requires wearing a pad at least once every six months rate at 10%

History of loss of sphincter control, currently asymptomatic rate at 0%

Note: Complete or partial loss of sphincter control refers to the inability to retain or expel stool at an appropriate time and place.

Explanation of terms:

Complete loss of sphincter control characterized by incontinence or retention that is not responsive to a physician-prescribed bowel program and requires either surgery or digital stimulation, medication (beyond laxative use), and special diet; or incontinence to solids and/or liquids two or more times per day, which requires changing a pad two or more times per day rate at 100%: This refers to the most severe form of impairment of sphincter control. Individuals with this condition experience complete loss of control over bowel movements, leading to incontinence or retention that does not improve with standard treatment. They may require surgical intervention, digital stimulation, medication beyond laxatives, and special diets. Alternatively, they may experience incontinence to solids and/or liquids more than two times per day, necessitating frequent pad changes.

Complete or partial loss of sphincter control characterized by incontinence or retention that is partially responsive to a physician-prescribed bowel program and requires either surgery or digital stimulation, medication (beyond laxative use), and special diet; or incontinence to solids and/or liquids two or more times per week, which requires wearing a pad two or more times per week rate at 60%: This describes a condition where individuals have either complete or partial loss of control over bowel movements. While there may be some response to treatment, they still require intervention such as surgery, digital stimulation, medication beyond laxatives, and special diets. Alternatively, they may experience incontinence to solids and/or liquids two or more times per week, requiring frequent pad changes.

Complete or partial loss of sphincter control characterized by incontinence or retention that is fully responsive to a physician-prescribed bowel program and requires digital stimulation, medication (beyond laxative use), and special diet; or incontinence to solids and/or liquids two or more times per month, which requires wearing a pad two or more times per month rate at 30%: This refers to individuals with either complete or partial loss of sphincter control, but their symptoms respond well to a prescribed bowel program. They may still require interventions like digital stimulation, medication beyond laxatives, and special diets. Alternatively, they may experience incontinence to solids and/or liquids two or more times per month, necessitating pad use.

Complete or partial loss of sphincter control characterized by incontinence or retention that is fully responsive to a physician-prescribed bowel program and requires medication or special diet; or incontinence to solids and/or liquids at least once every six months, which requires wearing a pad at least once every six months rate at 10%: In this category, individuals have either complete or partial loss of sphincter control, but their symptoms are well managed with medication or special diets. Alternatively, they may experience incontinence to solids and/or liquids at least once every six months, necessitating occasional pad use.

History of loss of sphincter control, currently asymptomatic rate at 0%: This category includes individuals with a documented history of sphincter control loss but are currently asymptomatic.

DC 7333, Rectum and anus, stricture of:

Inability to open the anus with inability to expel solid feces rate at 100%

Reduction of the lumen 50% or more, with pain and straining during defecation rate at 60%

Reduction of the lumen by less than 50%, with straining during defecation rate at 30%

Luminal narrowing with or without straining, managed by dietary intervention rate at 10%

Note (1): Conditions rated under this code include dyssynergic defecation (levator ani) and anismus (functional constipation).

Note (2): Evaluate an ostomy as Intestine, large, resection of (DC 7329).

Explanation of terms:

Inability to open the anus with inability to expel solid feces rate at 100%: This refers to a severe condition where there is a complete inability to open the anus, making it impossible to expel solid feces. It results in significant impairment and requires substantial assistance or intervention for bowel movements.

Reduction of the lumen 50% or more, with pain and straining during defecation rate at 60%: This describes a condition where there is a significant narrowing of the rectum or anus, making the passage of feces difficult. Individuals experience pain and strain during bowel movements due to the reduced lumen size.

Reduction of the lumen by less than 50%, with straining during defecation rate at 30%: In this case, there is a moderate reduction in the size of the rectum or anus, but it is less severe than the previous category. Individuals still experience straining during bowel movements due to the narrowing of the lumen.

Luminal narrowing with or without straining, managed by dietary intervention rate at 10%: This category includes individuals with luminal narrowing of the rectum or anus, which may or may not cause straining during defecation. However, their condition is manageable with dietary interventions.

Note (1): Conditions rated under this code include dyssynergic defecation (levator ani) and anismus (functional constipation). These are conditions where there is difficulty coordinating the muscles involved in defecation, leading to impaired bowel movements.

Note (2): Evaluate an ostomy as Intestine, large, resection of (DC 7329). An ostomy refers to a surgical procedure where an opening is created in the abdomen for waste elimination, often used in cases where the rectum or anus is dysfunctional or removed.

DC 7334, Rectum, prolapse of:

Persistent irreducible prolapse, repairable or unrepairable rate at 100%

Manually reducible prolapse that is not repairable and occurs at times other than bowel movements, exertion, or while performing the Valsalva Maneuver rate at 50%

Manually reducible prolapse that is not repairable and occurs only after bowel movements, exertion, or while performing the Valsalva Maneuver rate at 30%

Spontaneously reducible prolapse that is not repairable rate at 10%

Note (1): For repairable prolapse of the rectum, continue the 100% evaluation for two months following repair. Thereafter, determine the appropriate evaluation based on residuals by mandatory VA examination. Apply the provisions of § 3.105(e) of this chapter to any change in evaluation based upon that or any subsequent examination.

Note (2): Where impairment of sphincter control constitutes the predominant disability, rate under diagnostic code 7332 (Rectum and anus, impairment of sphincter control).

Explanation of terms:

Persistent irreducible prolapse, repairable or unrepairable rate at 100%: This refers to a rectal prolapse that cannot be pushed back into place and remains protruding from the anus continuously. It may or may not be amenable to surgical repair, but regardless, it causes significant impairment.

Manually reducible prolapse that is not repairable and occurs at times other than bowel movements, exertion, or while performing the Valsalva Maneuver rate at 50%: In this case, the prolapse can be manually pushed back into place, but it cannot be surgically repaired. However, it occurs at times other than during bowel movements, exertion, or the Valsalva Maneuver (a forced expiration against a closed airway). This condition still significantly impacts the individual’s functioning.

Manually reducible prolapse that is not repairable and occurs only after bowel movements, exertion, or while performing the Valsalva Maneuver rate at 30%: Similar to the previous category, the prolapse is manually reducible but not repairable surgically. However, it occurs specifically after bowel movements, exertion, or while performing the Valsalva Maneuver.

Spontaneously reducible prolapse that is not repairable rate at 10%: In this case, the prolapse spontaneously reduces back into place without manual assistance. However, it is not amenable to surgical repair and still causes impairment.

Note (1): For repairable prolapse of the rectum, the evaluation remains at 100% for two months following repair. After that period, the appropriate evaluation is determined based on residual symptoms, as assessed through a mandatory VA examination.

Note (2): If impairment of sphincter control is the predominant disability, it should be rated under diagnostic code 7332 (Rectum and anus, impairment of sphincter control). This code covers conditions related to the loss of control over the rectum and anus, which may be associated with rectal prolapse but constitute a separate disability.

DC 7335, Ano, fistula in, including anorectal fistula and anorectal abscess:

More than two constant or near-constant fistulas with abscesses, drainage, and pain, which are refractory to medical and surgical treatment rate at 60%

One or two simultaneous fistulas, with abscess, drainage, and pain rate at 40%

Two or more simultaneous fistulas with drainage and pain, but without abscesses rate at 20%

One fistula with drainage and pain, but without abscess rate at 10%

Explanation of terms:

More than two constant or near-constant fistulas with abscesses, drainage, and pain, which are refractory to medical and surgical treatment rate at 60%: This refers to the presence of multiple fistulas (abnormal passages) in the area around the anus, along with abscesses (collections of pus), continuous drainage, and pain. Despite attempts at both medical and surgical treatment, the condition remains persistent and difficult to manage, resulting in significant impairment.

One or two simultaneous fistulas, with abscess, drainage, and pain rate at 40%: In this case, there are one or two fistulas present simultaneously, along with abscesses, drainage, and associated pain. The condition may be somewhat less severe than the first category but still causes notable impairment.

Two or more simultaneous fistulas with drainage and pain, but without abscesses rate at 20%: This category involves the presence of two or more fistulas at the same time, accompanied by drainage and pain, but without the presence of abscesses. While less severe than the previous categories, it still results in impairment and discomfort.

One fistula with drainage and pain, but without abscess rate at 10%: Here, only one fistula is present, along with drainage and pain, but without the presence of abscesses. This represents a less severe form of the condition compared to the other categories but still warrants recognition and compensation.

DC 7336, Hemorrhoids, external or internal:

Internal or external hemorrhoids with persistent bleeding and anemia; or continuously prolapsed internal hemorrhoids with three or more episodes peryear of thrombosis rate at 20%

Prolapsed internal hemorrhoids with two or less episodes per year of thrombosis; or external hemorrhoids with three or more episodes per year of thrombosis rate at 10%

Explanation of terms:

Internal or external hemorrhoids with persistent bleeding and anemia; or continuously prolapsed internal hemorrhoids with three or more episodes per year of thrombosis (rate at 20%):

Internal hemorrhoids: These are swollen veins located in the rectum. They may bleed during bowel movements, leading to persistent bleeding and, in severe cases, anemia due to blood loss.

External hemorrhoids: These are swollen veins located around the anus. If they become thrombosed (filled with blood clots), they can cause pain, swelling, and discomfort.

Continuously prolapsed internal hemorrhoids: These are internal hemorrhoids that protrude from the anus and do not retract back into the rectum. If they remain prolapsed for an extended period, they can lead to complications such as thrombosis, where blood clots form inside the hemorrhoids.

Thrombosis: This refers to the formation of blood clots within the hemorrhoidal veins, causing pain, swelling, and inflammation.

Prolapsed internal hemorrhoids with two or less episodes per year of thrombosis; or external hemorrhoids with three or more episodes per year of thrombosis (rate at 10%):

Prolapsed internal hemorrhoids: These are internal hemorrhoids that protrude from the anus during bowel movements but spontaneously retract back into the rectum afterward. If they become thrombosed occasionally (two or fewer times per year), it leads to less frequent episodes of discomfort.

External hemorrhoids: Similar to before, these are swollen veins around the anus. If they experience thrombosis more frequently (three or more times per year), it causes recurrent episodes of pain, swelling, and inflammation.

In summary, DC 7336 describes different scenarios of internal or external hemorrhoids, considering factors such as bleeding, anemia, prolapse, and thrombosis, and assigns disability ratings based on the severity and frequency of associated symptoms.

DC 7337, Pruritus ani (anal itching):

With bleeding or excoriation rate at 10%

Without bleeding or excoriation rate at 0%

Explanation of terms:

With bleeding or excoriation (rate at 10%):

Pruritus ani: This refers to anal itching, a common condition characterized by an intense itching sensation around the anus.

Bleeding: Some individuals with pruritus ani may experience bleeding due to scratching the itchy area excessively, leading to irritation and abrasions (excoriation) of the skin.

Excoriation: Excoriation refers to the scraping or scratching of the skin, often resulting from itching. In the context of pruritus ani, excoriation can occur due to repeated scratching of the itchy anal area, leading to skin damage and possibly bleeding.

Without bleeding or excoriation (rate at 0%):

This refers to cases of pruritus ani where there is itching around the anus but without associated bleeding or excoriation.

Individuals experiencing anal itching without bleeding or excoriation typically have milder symptoms compared to those with bleeding or skin damage.

In summary, DC 7337 categorizes pruritus ani based on the presence or absence of bleeding or excoriation, with different disability ratings assigned accordingly. Pruritus ani can cause significant discomfort and impairment in quality of life, especially when associated with bleeding or skin damage.

DC 7338, Hernia, including femoral, inguinal, umbilical, ventral, incisional, and other (but not including hiatal)

Irreparable hernia (new or recurrent) present for 12 months or more; with both of the following present for 12 months or more: 1. Size equal to 15 cm or greater in one dimension; and 2. Pain when performing at least three of the following activities: (1) bending over, (2) activities of daily living (ADLs), (3) walking, and (4) climbing stairs rate at 100%

Irreparable hernia (new or recurrent) present for 12 months or more; with both of the following present for 12 months or more: 1. Size equal to 15 cm or greater in one dimension; and 2. Pain when performing two of the following activities: (1) bending over, (2) activities of daily living (ADLs), (3) walking, and (4) climbing stairs rate at 60%

Irreparable hernia (new or recurrent) present for 12 months or more; with both of the following present for 12 months or more: 1. Size equal to 3 cm or greater but less than 15 cm in one dimension; and 2. Pain when performing at least two of the following activities: (1) bending over, (2) activities of daily living (ADLs), (3) walking, and (4) climbing stairs rate at 30%

Irreparable hernia (new or recurrent) present for 12 months or more; with both of the following present for 12 months or more: 1. Size equal to 3 cm or greater but less than 15 cm in one dimension; and 2. Pain when performing one of the following activities: (1) bending over, (2) activities of daily living (ADLs), (3) walking, and (4) climbing stairs rate at 20%

Irreparable hernia (new or recurrent) present for 12 months or more; with hernia size smaller than 3 cm rate at 10%

Asymptomatic hernia; present and repairable, or repaired rate at 0%

Note (1): With two compensable inguinal hernias, evaluate the more severely disabling hernia first, and then add 10% to that rating to account for the second compensable hernia. Do not add 10% to that rating if the more severely disabling hernia is rated at 100%.

Note (2): Any one of the following activities of daily living are sufficient for evaluation: bathing, dressing, hygiene, and/or transfers.

Explanation of terms:

Irreparable hernia (new or recurrent) present for 12 months or more; with both of the following present for 12 months or more:

Size equal to 15 cm or greater in one dimension: This refers to the diameter or length of the hernia protrusion from its site of origin, with a size of 15 cm or larger indicating a significant hernia.

Pain when performing at least three of the following activities: Individuals with this type of hernia experience pain during specific activities, including bending over, activities of daily living (ADLs), walking, and climbing stairs.

Rate at 100%: This rating indicates the highest level of disability, reflecting the severe pain and impairment associated with a large irreparable hernia.

Irreparable hernia (new or recurrent) present for 12 months or more; with both of the following present for 12 months or more:

Similar to the previous category, but the requirement is pain during two of the listed activities.

Rate at 60%: This rating reflects a significant level of disability but is lower than the 100% rating due to experiencing pain during fewer activities.

Irreparable hernia (new or recurrent) present for 12 months or more; with both of the following present for 12 months or more:

This category involves hernias with a size between 3 cm and 15 cm in one dimension, along with pain during at least two of the listed activities.

Rate at 30%: Individuals in this category experience less severe pain and impairment compared to the higher-rated categories.

Irreparable hernia (new or recurrent) present for 12 months or more; with both of the following present for 12 months or more:

Similar to the previous category, but the requirement is pain during one of the listed activities.

Rate at 20%: This rating indicates a lower level of disability compared to the higher-rated categories, reflecting pain during fewer activities.

Irreparable hernia (new or recurrent) present for 12 months or more; with hernia size smaller than 3 cm:

This category involves smaller hernias, those with a size smaller than 3 cm.

Rate at 10%: Smaller hernias typically cause less pain and impairment, resulting in a lower disability rating.

Asymptomatic hernia; present and repairable, or repaired:

This category includes hernias that are either asymptomatic or have been successfully repaired.

Rate at 0%: As there are no symptoms or impairment associated with these hernias, they do not qualify for a disability rating.

Note: The disability ratings in DC 7338 are based on the size of the hernia, presence of pain during specific activities, and whether the hernia is repairable or irreparable. The severity of the symptoms and impairment determines the assigned rating, ranging from 0% for asymptomatic or repaired hernias to 100% for large irreparable hernias causing significant pain and disability. Additionally, compensation for multiple inguinal hernias follows specific guidelines outlined in the notes.

DC 7344, Benign neoplasms, exclusive of skin growths:

Evaluate under a diagnostic code appropriate to the predominant disability or the specific residuals after treatment.

Note: This diagnostic code includes lipoma, leiomyoma, colon polyps, or villous adenoma.

Explanation of terms:

Evaluate under a diagnostic code appropriate to the predominant disability or the specific residuals after treatment:

This means that the evaluation of benign neoplasms should be based on the symptoms, complications, or impairments they cause. Depending on the specific condition and its effects on the individual, it should be rated under the appropriate diagnostic code that reflects the severity of the disability or residual symptoms after treatment.

Note: This diagnostic code includes lipoma, leiomyoma, colon polyps, or villous adenoma:

This note specifies some examples of benign neoplasms that fall under DC 7344. These include:

Lipoma: A benign tumor made up of fat tissue.

Leiomyoma: A benign tumor derived from smooth muscle tissue, commonly found in the uterus (uterine fibroids) or gastrointestinal tract.

Colon polyps: Abnormal growths in the colon or rectum, which can sometimes develop into colon cancer if left untreated.

Villous adenoma: A type of benign tumor that arises from glandular tissue, often found in the colon and rectum.

In summary, DC 7344 encompasses various benign neoplasms, and the evaluation of these conditions should be based on the predominant disability or residual symptoms experienced by the individual, following appropriate diagnostic coding guidelines.

DC 7345, Chronic liver disease without cirrhosis:

Progressive chronic liver disease requiring use of both parenteral antiviral therapy (direct antiviral agents), and parenteral immunomodulatory therapy (interferon and other); and for six months following discontinuance of treatment rate at 100%

Progressive chronic liver disease requiring continuous medication and causing substantial weight loss and at least two of the following: (1) daily fatigue, (2) malaise, (3) anorexia, (4) hepatomegaly, (5) pruritus, and (6) arthralgia rate at 60%

Progressive chronic liver disease requiring continuous medication and causing minor weight loss and at least two of the following: (1) daily fatigue, (2) malaise, (3) anorexia, (4) hepatomegaly, (5) pruritus, and (6) arthralgia rate at 40%

Chronic liver disease with at least one of the following: (1) intermittent fatigue, (2) malaise, (3) anorexia, (4) hepatomegaly, or (5) pruritus rate at 20%

Previous history of liver disease, currently asymptomatic rate at 0%

Note (1): 100% evaluation shall continue for six months following discontinuance of parenteral antiviral therapy and administration of parenteral immunomodulatory drugs. Six months after discontinuance of parenteral antiviral therapy and parenteral immunomodulatory drugs, determine the appropriate disability rating by mandatory VA exam. Apply the provisions of § 3.105(e) of this chapter to any change in evaluation based upon that or any subsequent examination.

Note (2): For individuals for whom physicians recommend both parenteral antiviral therapy and parenteral immunomodulatory drugs, but for whom treatment is medically contraindicated, rate according to DC 7312 (Cirrhosis of the liver).

Note (3): This diagnostic code includes Hepatitis B (confirmed by serologic testing), primary biliary cirrhosis (PBC), primary sclerosing cholangitis (PSC), autoimmune liver disease, Wilson’s disease, Alpha-1-antitrypsin deficiency, hemochromatosis, drug-induced hepatitis, and non-alcoholic steatohepatitis (NASH). Track Hepatitis C (or non-A, non-B hepatitis) under DC 7354 but evaluate it using the criteria in this entry.

Note (4): Evaluate sequelae, such as cirrhosis or malignancy of the liver, under an appropriate diagnostic code, but do not use the same signs and symptoms as the basis for evaluation under DC 7354 and under a diagnostic code for sequelae. (See § 4.14)

Explanation of terms:

Progressive chronic liver disease requiring use of both parenteral antiviral therapy (direct antiviral agents), and parenteral immunomodulatory therapy (interferon and other); and for six months following discontinuance of treatment rate at 100%:

This category involves severe chronic liver disease that necessitates the use of both antiviral and immunomodulatory therapies administered intravenously. The individual receives a 100% rating during the treatment period and for six months after treatment cessation.

Progressive chronic liver disease requiring continuous medication and causing substantial weight loss and at least two of the following: (1) daily fatigue, (2) malaise, (3) anorexia, (4) hepatomegaly, (5) pruritus, and (6) arthralgia rate at 60%:

This classification denotes chronic liver disease that leads to significant weight loss and at least two accompanying symptoms such as fatigue, malaise, loss of appetite, enlarged liver, itching, or joint pain. It warrants a 60% disability rating.

Progressive chronic liver disease requiring continuous medication and causing minor weight loss and at least two of the following: (1) daily fatigue, (2) malaise, (3) anorexia, (4) hepatomegaly, (5) pruritus, and (6) arthralgia rate at 40%:

In this category, chronic liver disease results in minor weight loss and two or more associated symptoms, leading to a 40% disability rating.

Chronic liver disease with at least one of the following: (1) intermittent fatigue, (2) malaise, (3) anorexia, (4) hepatomegaly, or (5) pruritus rate at 20%:

Individuals experiencing intermittent fatigue, malaise, loss of appetite, enlarged liver, or itching due to chronic liver disease receive a 20% disability rating.

Previous history of liver disease, currently asymptomatic rate at 0%:

Individuals with a past history of liver disease but currently without symptoms are rated at 0% disability.

The notes provide additional guidance, including the duration of evaluation following treatment cessation, considerations for medical contraindications, and examples of conditions covered under this diagnostic code.

DC 7346, Hiatal hernia and paraesophageal hernia:

Rate as esophagus, stricture of (DC 7203).

Explanation of terms:

Both hiatal hernias and paraesophageal hernias are types of hernias involving the stomach. However, for rating purposes, these conditions are assessed under the diagnostic code for esophagus, stricture of (DC 7203). This means that the severity and impact of these hernias on the esophagus, particularly if they cause strictures (narrowing), are evaluated according to the criteria specified for esophageal strictures. This allows for a consistent and standardized approach to rating these hernias based on their effect on the esophagus.

DC 7347, Pancreatitis, chronic:

Daily episodes of abdominal or mid-back pain that require three or more hospitalizations per year; and pain management by a physician; and maldigestion and malabsorption requiring dietary restriction and pancreatic enzyme supplementation rate at 100%

Three or more episodes of abdominal or mid-back pain per year and at least one episode per year requiring hospitalization for management either of complications related to abdominal pain or complications of tube enteral feeding rate at 60%

At least one episode per year of abdominal or mid-back pain that requires ongoing outpatient medical treatment for pain, digestive problems, or management of related complications including but not limited to cyst, pseudocyst, intestinal obstruction, or ascites rate at 30%

Note (1): Appropriate diagnostic studies must confirm that abdominal pain in this condition results from pancreatitis.

Note (2): Separately rate endocrine dysfunction resulting in diabetes due to pancreatic insufficiency under DC 7913 (Diabetes mellitus).

Explanation of terms:

Daily episodes of abdominal or mid-back pain that require three or more hospitalizations per year; and pain management by a physician; and maldigestion and malabsorption requiring dietary restriction and pancreatic enzyme supplementation rate at 100%:

This rating is assigned when the individual experiences persistent, severe pain in the abdomen or mid-back on a daily basis, necessitating frequent hospitalizations for pain management. Additionally, the condition leads to maldigestion and malabsorption, requiring dietary restrictions and supplementation with pancreatic enzymes.

Three or more episodes of abdominal or mid-back pain per year and at least one episode per year requiring hospitalization for management either of complications related to abdominal pain or complications of tube enteral feeding rate at 60%:

This rating applies when the individual experiences recurrent episodes of abdominal or mid-back pain, with at least three episodes per year. Additionally, there’s at least one episode per year requiring hospitalization either due to complications related to the pain or complications of tube enteral feeding.

At least one episode per year of abdominal or mid-back pain that requires ongoing outpatient medical treatment for pain, digestive problems, or management of related complications including but not limited to cyst, pseudocyst, intestinal obstruction, or ascites rate at 30%:

Here, the individual experiences at least one episode per year of abdominal or mid-back pain requiring ongoing outpatient medical treatment. The treatment addresses pain management, digestive issues, or management of complications like cysts, pseudocysts, intestinal obstruction, or ascites.

Notes:

Diagnostic studies must confirm that abdominal pain results from pancreatitis.

Endocrine dysfunction resulting in diabetes due to pancreatic insufficiency is rated separately under DC 7913 (Diabetes mellitus).

DC 7348, Vagotomy with pyloroplasty or gastroenterostomy:

Following confirmation of postoperative complications of stricture or continuing gastric retention rate at 40%

With symptoms and confirmed diagnosis of alkaline gastritis, or with confirmed persisting diarrhea rate at 30%

With incomplete vagotomy rate at 20%

Note: Rate recurrent ulcer following complete vagotomy under DC 7304 (Peptic ulcer disease), with a minimum rating of 20%; and rate post- operative residuals not addressed by this diagnostic code under DC 7303 (Chronic complications of upper gastrointestinal surgery).

Explanation of terms:

Following confirmation of postoperative complications of stricture or continuing gastric retention rate at 40%:

If there are complications after the surgery such as stricture (narrowing) or ongoing gastric retention (inability of the stomach to empty properly), this warrants a 40% rating.

With symptoms and confirmed diagnosis of alkaline gastritis, or with confirmed persisting diarrhea rate at 30%:

If there are symptoms along with a confirmed diagnosis of alkaline gastritis (inflammation of the stomach lining) or persisting diarrhea, this condition merits a 30% rating.

With incomplete vagotomy rate at 20%:

If the vagotomy, a surgical procedure where part of the vagus nerve is cut to reduce acid secretion in the stomach, is incomplete, meaning it wasn’t fully successful or didn’t achieve its intended outcome, this receives a 20% rating.

Note:

Recurrent ulcers following complete vagotomy are rated under DC 7304 (Peptic ulcer disease) with a minimum rating of 20%. Post-operative residuals not addressed by this diagnostic code are rated under DC 7303 (Chronic complications of upper gastrointestinal surgery).

DC 7350, Liver abscess:

Assign a rating of 100% for 6 months from the date of initial diagnosis. Six months following initial diagnosis, determine the appropriate disability rating by mandatory VA examination. Thereafter, rate the condition based on chronic residuals under the appropriate body system. Apply the provisions of § 3.105(e) of this chapter to any reduction in evaluation.

Note: This diagnostic code includes abscesses caused by bacterial, viral, amebic (e.g., E. hystolytica), fungal (e.g., C. albicans), and other agents.

Explanation of terms:

Assign a rating of 100% for 6 months from the date of initial diagnosis:

When a liver abscess is diagnosed, it is initially rated at 100% disability for a period of 6 months from the date of diagnosis.

Six months following initial diagnosis, determine the appropriate disability rating by mandatory VA examination:

After the initial 6-month period, the disability rating is reevaluated through a mandatory VA examination to determine the appropriate rating based on the chronic residuals or long-term effects of the condition.

Thereafter, rate the condition based on chronic residuals under the appropriate body system:

After the initial 6-month period and subsequent evaluation, the condition is rated based on any chronic residuals or lasting effects it may have on the body.

Apply the provisions of § 3.105(e) of this chapter to any reduction in evaluation: Any reduction in evaluation after the initial 6-month period and subsequent reevaluation is subject to the provisions outlined in § 3.105(e) of the relevant regulations. This section likely pertains to the criteria for adjusting disability ratings based on changes in the severity of the condition or its impact on the individual’s health.

Note:

This diagnostic code encompasses liver abscesses caused by various agents, including bacteria, viruses, amoebas (such as E. histolytica), fungi (such as C. albicans), and others.

DC 7351, Liver transplant:

For an indefinite period from the date of hospital admission for transplant surgery rate at 100%

Eligible and awaiting transplant surgery, minimum rating of 60%

Following transplant surgery, minimum rating of 30%

Note: Assign a rating of 100% as of the date of hospital admission for transplant surgery. One year following discharge, determine the appropriate disability rating by mandatory VA examination. Apply the provisions of § 3.105(e) of this chapter to any change in evaluation based upon that or any subsequent examination. Rate residuals of any recurrent underlying liver disease under the appropriate diagnostic code and, when appropriate, combine with other post-transplant residuals under the appropriate body system(s), subject to the provisions of § 4.14 and this section.

Explanation of terms:

For an indefinite period from the date of hospital admission for transplant surgery rate at 100%:

Individuals who undergo liver transplant surgery are initially rated at 100% disability for an indefinite period starting from the date of their hospital admission for the transplant surgery.

Eligible and awaiting transplant surgery, minimum rating of 60%:

Individuals who are deemed eligible for liver transplant surgery but are awaiting the procedure receive a minimum disability rating of 60%. This rating reflects the severity of their condition and the need for transplantation.

Following transplant surgery, minimum rating of 30%:

After undergoing liver transplant surgery, individuals receive a minimum disability rating of 30%. This rating recognizes the ongoing medical needs and potential complications associated with the transplant surgery.

Note:

A rating of 100% is assigned as of the date of hospital admission for transplant surgery.

One year following discharge from the hospital, a mandatory VA examination is conducted to determine the appropriate disability rating based on the individual’s condition post-transplant.

Any change in evaluation based on subsequent examinations is subject to the provisions outlined in § 3.105(e) of the relevant regulations.

Residuals of any recurrent underlying liver disease are rated separately under the appropriate diagnostic code. Post-transplant residuals are also evaluated under the relevant body system(s), and if applicable, the ratings may be combined, considering the provisions outlined in § 4.14 and the pertinent regulations.

DC 7352, Pancreas transplant:

For an indefinite period from the date of hospital admission for transplant surgery rate at 100%

Minimum rating of 30%

Explanation of terms:

For an indefinite period from the date of hospital admission for transplant surgery rate at 100%:

Individuals who undergo pancreas transplant surgery are initially rated at 100% disability for an indefinite period starting from the date of their hospital admission for the transplant surgery. This reflects the significant impact of the procedure and the recovery period.

Minimum rating of 30%:

After pancreas transplant surgery, individuals receive a minimum disability rating of 30%. This rating acknowledges the ongoing medical needs and potential complications associated with the transplant surgery, even after the initial recovery period.

Note:

A rating of 100% is assigned as of the date of hospital admission for transplant surgery.

One year following discharge from the hospital, a mandatory VA examination is conducted to determine the appropriate disability rating based on the individual’s condition post-transplant.

Any change in evaluation based on subsequent examinations is subject to the provisions outlined in § 3.105(e) of the relevant regulations.

DC 7354, Hepatitis C (or non-A, non-B hepatitis):

Rate under DC 7345 (Chronic liver disease without cirrhosis).

Explanation of terms:

Rate under DC 7345 (Chronic liver disease without cirrhosis):

Individuals with Hepatitis C are evaluated and rated under the criteria outlined in DC 7345, which addresses chronic liver disease without cirrhosis. This means that the disability rating for Hepatitis C is determined based on the severity of the chronic liver disease symptoms and complications, excluding cirrhosis.

In summary, DC 7354 directs the evaluation and rating of Hepatitis C under the criteria specified in DC 7345, which focuses on chronic liver disease without cirrhosis.

DC 7355, Celiac disease:

Malabsorption syndrome with weakness which interferes with activities of daily living; and weight loss resulting in wasting and nutritional deficiencies; and with systemic manifestations including but not limited to, weakness and fatigue, dermatitis, lymph node enlargement, hypocalcemia, low vitamin levels; and anemia related to malabsorption; and episodes of abdominal pain and diarrhea due to lactase deficiency or pancreatic insufficiency rate at 80%

Malabsorption syndrome with chronic diarrhea managed by medically- prescribed dietary intervention such as prescribed gluten-free diet, with nutritional deficiencies due to lactase and pancreatic insufficiency; and with systemic manifestations including, but not limited to, weakness and fatigue, dermatitis, lymph node enlargement, hypocalcemia, low vitamin levels, or atrophy of the inner intestinal lining shown on biopsy rate at 50%

Malabsorption syndrome with chronic diarrhea managed by medically- prescribed dietary intervention such as prescribed gluten-free diet; and without nutritional deficiencies rate at 30%

Note (1): An appropriate serum antibody test or endoscopy with biopsy must

confirm the diagnosis.

Note (2): For evaluation of celiac disease with the predominant disability of

malabsorption, use the greater evaluation between DC 7328 or celiac

disease under DC 7355.

Explanation of terms:

Malabsorption syndrome with weakness interfering with activities of daily living; weight loss resulting in wasting and nutritional deficiencies; systemic manifestations including but not limited to weakness, fatigue, dermatitis, lymph node enlargement, hypocalcemia, low vitamin levels; anemia related to malabsorption; and episodes of abdominal pain and diarrhea due to lactase deficiency or pancreatic insufficiency rated at 80%:

This indicates severe symptoms and complications associated with Celiac disease, including significant weakness affecting daily activities, weight loss leading to wasting, various systemic manifestations such as dermatitis and lymph node enlargement, and gastrointestinal issues like abdominal pain and diarrhea due to malabsorption.

Malabsorption syndrome with chronic diarrhea managed by medically-prescribed dietary intervention such as a gluten-free diet, with nutritional deficiencies due to lactase and pancreatic insufficiency; and systemic manifestations including weakness, fatigue, dermatitis, lymph node enlargement, hypocalcemia, low vitamin levels, or atrophy of the inner intestinal lining shown on biopsy rated at 50%:

This category describes chronic diarrhea managed with a gluten-free diet but still experiencing nutritional deficiencies and systemic manifestations.

Malabsorption syndrome with chronic diarrhea managed by medically-prescribed dietary intervention such as a gluten-free diet; and without nutritional deficiencies rated at 30%:

This refers to Celiac disease with chronic diarrhea managed by a gluten-free diet without significant nutritional deficiencies.

Note (1): Diagnosis confirmation requires appropriate tests such as serum antibody tests or endoscopy with biopsy.

Note (2): When evaluating Celiac disease with malabsorption as the primary disability, the higher evaluation between DC 7328 (related to intestine resection) and Celiac disease under DC 7355 should be applied.

DC 7356, Gastrointestinal dysmotility syndrome:

Requiring complete dependence on total parenteral nutrition (TPN) or continuous tube feeding for nutritional support rate at 80%

Requiring intermittent tube feeding for nutritional support; with recurrent emergency treatment for episodes of intestinal obstruction or regurgitation due to poor gastric emptying, abdominal pain, recurrent nausea, or recurrent vomiting rate at 50%

With symptoms of chronic intestinal pseudo-obstruction (CIPO) or symptoms of intestinal motility disorder, including but not limited to, abdominal pain, bloating, feeling of epigastric fullness, dyspepsia, nausea and vomiting, regurgitation, constipation, and diarrhea, managed by ambulatory care; and requiring prescribed dietary management or manipulation rate at 30%

Intermittent abdominal pain with epigastric fullness associated with bloating; and without evidence of a structural gastrointestinal disease rate at 10%

Note: Use this diagnostic code for illnesses associated with § 3.317(a)(2)(i)(B)(3) of this chapter, other than those which can be evaluated under DC 7319.

Explanation of terms:

Requiring complete dependence on total parenteral nutrition (TPN) or continuous tube feeding for nutritional support rated at 80%: This indicates a severe form of gastrointestinal dysmotility syndrome where the individual is entirely reliant on TPN or continuous tube feeding for nutritional support.

Requiring intermittent tube feeding for nutritional support; with recurrent emergency treatment for episodes of intestinal obstruction or regurgitation due to poor gastric emptying, abdominal pain, recurrent nausea, or recurrent vomiting rated at 50%: This category signifies a condition where the individual needs intermittent tube feeding for nutrition but experiences recurrent emergencies due to issues like intestinal obstruction, regurgitation, abdominal pain, nausea, or vomiting caused by poor gastric emptying.

With symptoms of chronic intestinal pseudo-obstruction (CIPO) or symptoms of intestinal motility disorder, managed by ambulatory care; and requiring prescribed dietary management or manipulation rated at 30%: This pertains to individuals experiencing symptoms of chronic intestinal pseudo-obstruction or other intestinal motility disorders managed through outpatient care, with prescribed dietary management or manipulation.

Intermittent abdominal pain with epigastric fullness associated with bloating; and without evidence of a structural gastrointestinal disease rated at 10%: This category covers individuals experiencing intermittent abdominal pain with bloating and epigastric fullness but without any evidence of structural gastrointestinal disease.

Note: This diagnostic code is used for illnesses associated with gastrointestinal dysmotility syndrome as per § 3.317(a)(2)(i)(B)(3) of the VA Schedule for Rating Disabilities, except those that can be evaluated under DC 7319.

DC 7357, Post pancreatectomy syndrome:

Following total or partial pancreatectomy, evaluate under Pancreatitis, chronic (DC 7347), Chronic complications of upper gastrointestinal surgery (DC 7303), or based on residuals such as malabsorption (Intestine, small, resection of, DC 7328), diarrhea (Irritable bowel syndrome, DC 7319, or Crohn’s disease or undifferentiated form of inflammatory bowel disease, DC 7326), or diabetes (DC 7913), whichever provides the highest evaluation.

The minimum rating is 30%

Explanation of terms:

Following total or partial pancreatectomy, evaluate under Pancreatitis, chronic (DC 7347), Chronic complications of upper gastrointestinal surgery (DC 7303), or based on residuals such as malabsorption (Intestine, small, resection of, DC 7328), diarrhea (Irritable bowel syndrome, DC 7319, or Crohn’s disease or undifferentiated form of inflammatory bowel disease, DC 7326), or diabetes (DC 7913), whichever provides the highest evaluation: This instruction directs how to assess the disability resulting from post pancreatectomy syndrome. It suggests that the evaluation should be based on the specific residuals or complications experienced by the individual after total or partial pancreatectomy. Depending on the predominant disability, the rating should be determined under various diagnostic codes such as chronic pancreatitis, chronic complications of upper gastrointestinal surgery, malabsorption, diarrhea, or diabetes, whichever results in the highest evaluation.

The minimum rating is 30%: This indicates that the disability rating for post pancreatectomy syndrome should not be less than 30%.

About the Author

Brian Reese

Brian Reese is one of the top VA disability benefits experts in the world and bestselling author of You Deserve It: The Definitive Guide to Getting the Veteran Benefits You’ve Earned (Second Edition).

Brian’s frustration with the VA claim process led him to create VA Claims Insider, which provides disabled veterans with tips, strategies, and lessons learned to win their VA disability compensation claim, faster, even if they’ve already filed, been denied, gave up, or don’t know where to start.

As the founder of VA Claims Insider and CEO of Military Disability Made Easy, he has helped serve more than 10 million military members and veterans since 2013 through free online educational resources.

He is a former active duty Air Force officer with extensive experience leading hundreds of individuals and multi-functional teams in challenging international environments, including a combat tour to Afghanistan in 2011 supporting Operation ENDURING FREEDOM.

Brian is a Distinguished Graduate of Management from the United States Air Force Academy, Colorado Springs, CO, and he holds an MBA from Oklahoma State University’s Spears School of Business, Stillwater, OK, where he was a National Honor Scholar (Top 1% of Graduate School class).

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VA Rating Changes for the Digestive System: The Ultimate Guide

List of the 47 VA Disability Digestive System Updates

DC 7200, Soft tissue injury of the mouth, other than tongue or lips:

DC 7201, Lips, injuries of:

DC 7202, Tongue, loss of whole or part:

DC 7203, Esophagus, stricture of:

DC 7204, Esophageal motility disorder:

DC 7205, Esophagus, diverticulum of, acquired:

DC 7206, Gastroesophageal reflux disease (GERD):

DC 7207, Barrett’s esophagus:

DC 7301, Peritoneum, adhesions of, due to surgery, trauma, disease, or infection:

DC 7303, Chronic complications of upper gastrointestinal surgery:

DC 7304, Peptic ulcer disease:

DC 7307, Gastritis, chronic:

DC 7308, Postgastrectomy syndrome:

DC 7309, Stomach, stenosis of:

DC 7310, Stomach, injury of, residuals:

DC 7312, Cirrhosis of the liver:

DC 7314, Chronic biliary tract disease:

DC 7315, Cholelithiasis, chronic:

DC 7317, Gallbladder, injury of:

DC 7318, Cholecystectomy (gallbladder removal), complications of (such as strictures and biliary leaks):

DC 7319, Irritable bowel syndrome (IBS):

DC 7323, Colitis, ulcerative:

DC 7325, Enteritis, chronic:

DC 7326, Crohn’s disease or undifferentiated form of inflammatory bowel disease:

DC 7327, Diverticulitis and diverticulosis:

DC 7328, Intestine, small, resection of:

DC 7329, Intestine, large, resection of:

DC 7330, Intestinal fistulous disease, external:

DC 7332, Rectum and anus, impairment of sphincter control:

DC 7333, Rectum and anus, stricture of:

DC 7334, Rectum, prolapse of:

DC 7335, Ano, fistula in, including anorectal fistula and anorectal abscess:

DC 7336, Hemorrhoids, external or internal:

DC 7337, Pruritus ani (anal itching):

DC 7338, Hernia, including femoral, inguinal, umbilical, ventral, incisional, and other (but not including hiatal)

DC 7344, Benign neoplasms, exclusive of skin growths:

DC 7345, Chronic liver disease without cirrhosis:

DC 7346, Hiatal hernia and paraesophageal hernia:

DC 7347, Pancreatitis, chronic:

DC 7348, Vagotomy with pyloroplasty or gastroenterostomy:

DC 7350, Liver abscess:

DC 7351, Liver transplant:

DC 7352, Pancreas transplant:

DC 7354, Hepatitis C (or non-A, non-B hepatitis):

DC 7355, Celiac disease:

DC 7356, Gastrointestinal dysmotility syndrome:

DC 7357, Post pancreatectomy syndrome:

About the Author

Brian Reese

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