- Diagnostic Code
- 7304
- CFR Section
- §4.114 — Digestive
Rating Tiers
Post-operative for perforation or hemorrhage, for three months
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
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
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
History of peptic ulcer disease documented by endoscopy or diagnostic imaging studies
What Raters Look For
Based on M21-1 adjudication criteria for Digestive conditions. These are the factors a VA rater evaluates when assigning a rating percentage.
M21-1 III.iv.4.D- •Weight loss — documented weight changes in treatment records
- •Frequency and severity of symptoms: pain, nausea, vomiting, diarrhea
- •Dietary restrictions required due to the condition
- •Need for surgical intervention, feeding tubes, or colostomy
- •Imaging and endoscopy findings (scope reports, biopsy results)
- •Hepatic function if liver disease is involved: bilirubin, albumin, INR, Child-Pugh score