- Diagnostic Code
- 7825
- CFR Section
- §4.118 — Skin
Rating Tiers
60%
Chronic refractory urticaria that requires third line treatment for control (e.g., plasmapheresis, immunotherapy, immunosuppressives) due to ineffectiveness with first and second line treatments
30%
Chronic urticaria that requires second line treatment (e.g., corticosteroids, sympathomimetics, leukotriene inhibitors, neutrophil inhibitors, thyroid hormone) for control
10%
Chronic urticaria that requires first line treatment (antihistamines) for control
What Raters Look For
Based on M21-1 adjudication criteria for Skin conditions. These are the factors a VA rater evaluates when assigning a rating percentage.
M21-1 III.iv.4.H- •Percentage of total body surface area (TBSA) affected — documented in dermatology notes
- •Location: whether the affected area includes exposed skin (face, hands, etc.)
- •Treatment required: topical only vs. systemic therapy (oral medications, biologics, phototherapy)
- •Frequency of medical visits for treatment or flares
- •Disfigurement — scarring, discoloration, or tissue loss visible on exam
- •Impact on daily activities and occupational function
NoteSystemic therapy requirement is often the key factor that moves a rating from 30% to 60%. Documentation of oral or injectable medications is critical.