- Diagnostic Code
- 7347
- CFR Section
- §4.114 — Digestive
Rating Tiers
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
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
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
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