- Diagnostic Code
- 6817
- CFR Section
- §4.97 — Respiratory
Rating Tiers
Primary pulmonary hypertension, or; chronic pulmonary thromboembolism with evidence of pulmonary hypertension, ventricular hypertrophy, or cor pulmonale, or; pulmonary hypertension secondary to other obstructive disease of pulmonary arteries or veins with evidence of ventricular hypertrophy or cor pulmonale
Chronic pulmonary thromboembolism requiring anticoagulant therapy, or; following inferior vena cava surgery without evidence of pulmonary hypertension or ventricular dysfunction
Symptomatic, following resolution of acute pulmonary embolism
Asymptomatic, following resolution of pulmonary thromboembolism
Rated Under Formula
This condition is rated using the §4.97 general rating formula.
What Raters Look For
Based on M21-1 adjudication criteria for Respiratory conditions. These are the factors a VA rater evaluates when assigning a rating percentage.
M21-1 III.iv.4.B- •Pulmonary function test results: FEV1 (% of predicted), FVC, FEV1/FVC ratio, and DLCO
- •Exercise tolerance in METs (metabolic equivalents) if cardiac limitation is also relevant
- •Frequency of exacerbations requiring medical visits, oral steroids, or hospitalization
- •Oxygen therapy use — whether prescribed and under what conditions
- •Sleep study results and AHI score if sleep apnea is claimed
- •Medication regimen: inhalers, systemic steroids, biologics
- •Smoking history (noted but not used to reduce rating)