- Diagnostic Code
- 7704
- CFR Section
- §4.117 — Hemic & Lymphatic
Rating Tiers
Requiring peripheral blood or bone marrow stem-cell transplant or chemotherapy (including myelosuppressants) for the purpose of ameliorating the symptom burden
Requiring phlebotomy 6 or more times per 12-month period or molecularly targeted therapy for the purpose of controlling RBC count
Requiring phlebotomy 4-5 times per 12-month period, or if requiring continuous biologic therapy or myelosuppressive agents, to include interferon, to maintain platelets <200,000 or white blood cells (WBC) <12,000
Requiring phlebotomy 3 or fewer times per 12-month period or if requiring biologic therapy or interferon on an intermittent basis as needed to maintain all blood values at reference range levels
What Raters Look For
Based on M21-1 adjudication criteria for Hemic & Lymphatic conditions. These are the factors a VA rater evaluates when assigning a rating percentage.
M21-1 III.iv.4.G- •Complete blood count (CBC) values: hemoglobin, platelet count, white cell count
- •Whether transfusions are required and how frequently
- •Bone marrow biopsy or transplant history
- •Response to treatment and current treatment regimen
- •Constitutional symptoms: fatigue, weight loss, fever