- Diagnostic Code
- 7330
- CFR Section
- §4.114 — Digestive
Rating Tiers
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
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
Intermittent fecal discharge with persistent drainage for more than 3 months in the past 12 months
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