- Diagnostic Code
- 7319
- CFR Section
- §4.114 — Digestive
Rating Tiers
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
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
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
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