The Digestive System

Topics:

The Mouth
The Esophagus
The Stomach
The Pancreas
The Gallbladder
The Liver and Hepatitis
The Intestines (Colon)
The Rectum and Anus
The Abdomen and Peritoneum
Ulcers
Hernias
Cancer and Tumors of the Digestive System
Other Digestive Conditions
DBQs for Digestive Conditions
Principles that Apply

Reminder: The VA will give a Military Disability Rating for each service-connected condition a service member has, but the DoD will only rate service-connected conditions that make a service member Unfit for Duty.

The digestive system is a network of organs that turn food into nutrients (absorbed into the body) or waste (ejected as feces, more awesomely known as “poo”). The digestive system is made up of the lips, mouth, tongue, esophagus, stomach, pancreas, liver, gall bladder, small intestine, large intestine/colon, rectum, and anus.

Organs of the Digestive System

When rating conditions of the digestive system, it is important to note that a single condition can only be rated ONE time. This principle is particularly important in the digestive system, because a condition in the stomach and a condition in the large intestine can cause the same symptoms. Contrary to what you think, though, both CANNOT be rated. In this case, same symptoms, same condition. Only one rating allowed.

In addition to this principle, the following codes cannot be used together (only one of them can be used at a time): 7301-7329, 7331, 7342, and 7345-7348. If you have two conditions make sure to check that they aren’t both one of these. If there are multiple conditions that have these codes, use the one that gives the highest rating.

 


The Mouth

The lips, tongue and mouth are all considered a part of the digestive system since they help take in and process food.

Code 7200: The mouth does not have its own rating system under this code. If there is an injury to the mouth, it is either rated on how it affects the ability to chew food (see the Mouth and Teeth page) or on any visible disfigurement to the face (code 7800). The final code for this condition will look like this: 7200-7800. The first four-digit code defines the condition as an injury of the mouth, and the second four-digit code tells how it is rated.

Code 7201: Any injury to the lips is also rated under code 7800 as a disfiguring scar. The final code for this condition will look like this: 7201-7800. The first four-digit code defines the condition as an injury of the mouth, and the second four-digit code tells how it is rated.

Code 7202: The tongue is only rated if a part of it has been lost. If half or more of the tongue is gone, then it is rated 60%. This rating can increase to 100% if the loss of the tongue makes it impossible to speak. If any amount of loss of the tongue causes significant trouble speaking, the minimum rating is 30%.

Code 6276: If the sense of taste is completely lost, it is rated 10%.

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The Esophagus

The esophagus is the tube that connects the mouth to the stomach.

Code 7203: A stricture of the esophagus occurs when the esophagus narrows and tightens, making it hard to swallow. If it is so narrowed that only liquids can be swallowed, it is rated 50%. If only being able to swallow liquids also causes a serious decrease in overall health, then it is rated 80%. If the esophagus is seriously narrowed, but some things besides liquids can also be swallowed, then it is rated 30%.

Code 7204: Spasms of the esophagus can occur when the muscles in the esophagus are unable to move food down to the stomach, often causing chest pain and various troubles eating. If this condition can be fixed with dilation treatment, then it is not ratable. If it cannot, then it is rated as a stricture of the esophagus, code 7203. The final code would look like this: 7204-7203. The first four-digit code defines it as spasms of the esophagus, and the second four-digit code tells how it is rated.

Code 7205: Diverticulum of the esophagus is a bubble or pocket of stretched tissue that pushes through the muscle wall of the esophagus. It normally occurs in people in their 50s, but can be a birth defect (these are not ratable). These pockets are caused by areas of weak muscle that cannot stand against the pressure of swallowing. They can also form through strong muscle if there is a swallowing disorder that causes extra pressure. This condition is only ratable if it causes problems with swallowing. It is then rated under code 7203. The final code would look like this: 7205-7203. The first four-digit code defines it as diverticulum of the esophagus, and the second four-digit code tells how it is rated.

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The Stomach

The stomach is a sac in the abdomen that uses acid to break down the food we eat.

Code 7307: Chronic hypertrophic gastritis is the swelling of the stomach and glands that continues over a long period of time and often leads to cancer. To be rated under this code, the condition must be diagnosed and confirmed by endoscopy. If there is severe bleeding in the stomach or large tears or breaks (ulcers) in the stomach wall, it is rated 60%. If there are small tears or breaks in the stomach wall and symptoms like stomach pain, it is rated 30%. If there are nodular lesions in the stomach and symptoms like stomach pain, it is rated 10%.

Atrophic gastritis is the swelling of the stomach caused by a disease. This condition is rated under the condition that caused the gastritis.

Code 7308: A gastrectomy is the full or partial removal of the stomach which could lead to many Postgastrectomy Syndromes. If the syndromes are severe and cause nausea, sweating, problems with blood circulation after meals, diarrhea, low blood sugar symptoms like seizures or slow brain functioning, and weight loss with malnutrition and anemia, it is rated 60%. If the syndromes are moderate and cause occasional mild problems with blood circulation after meals, diarrhea and weight loss, it is rated 40%. If the syndromes are mild and only cause mild problems with blood circulation every now and then or if there are constant but mild symptoms like diarrhea, weight loss or low blood sugar, it is rated 20%.

Code 7309: Stenosis of the stomach is when the stomach becomes abnormally narrowed. This most commonly occurs at the lower part of the stomach (pyloris) where food passes from the stomach to the small intestine. This condition is rated as a gastric ulcer. The final code would look like this: 7309-7304. The first four-digit code defines it as stenosis of the stomach, and the second four-digit code tells how it is rated.

Code 7310: Any lasting symptoms after an injury to the stomach are rated as peritoneal adhesions. The final code would look like this: 7310-7301. The first four-digit code defines it as a stomach injury, and the second four-digit code tells how it is rated.

Code 7348: A vagotomy is a surgical procedure where the vagus nerve, which stimulates the production of stomach acid, is cut in order to reduce the amount of acid produced in the stomach. To qualify for a rating, the surgery must have been performed with either a gastroenterostomy or a pyloroplasty as well.

After the surgery, if there continues to be significant problems with food passing from the stomach to the small intestine, it is rated 40%. If there is a definite diagnosis of alkaline gastritis or regular diarrhea, it is rated 30%. If the surgery was not successful in decreasing the amount of acid production and an ulcer forms or reforms, it is rated 20%. If the surgery was successful, but an ulcer reforms anyway, it is then rated under code 7305 with the minimum rating of 20%. The final code in that case would be 7348-7305. The first four-digit code defines it as a vagotomy, and the second four-digit code tells how it is rated.

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The Pancreas

The pancreas is both a gland in the endocrine system and a gland for the digestive system. If the pancreatic condition interferes with its function in the endocrine system, it is rated under that system. If it interferes with its function in the digestive system, it is rated below.

For the digestive system, the pancreas creates important enzymes that help the small intestine absorb the necessary nutrients.

Code 7347: Pancreatitis is the swelling of the pancreas that occurs because the enzymes it produces become active while still in the pancreas. If diabetes and pancreatitis are both present, both cannot be rated. Rate only the one that gives the highest rating. If the whole or part of the pancreas is surgically removed, then rate any continuing symptoms on the following ratings, with the minimum rating of 30%.

Ratings: If there are seriously disabling attacks of stomach pain with very few pain-free periods, significant amounts of fat in the feces, the inability of the small intestine to absorb the necessary nutrients, diarrhea, and severe malnutrition, it is rated 100%.

If there are frequent attacks of disabling stomach pain, weight loss (lower than the average weight weighed over the last year), and other symptoms like diarrhea or significant amounts of fat in the feces, it is rated 60%.

If there are at least 4 to 7 attacks of disabling stomach pain each year, it is rated 30%.

If there is at least 1 attack of disabling stomach pain each year, it is rated 10%.

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The Gallbladder

The gallbladder collects bile produced by the liver and passes it along to the stomach when digesting food. The bile helps digest fats.

Code 7314: Chronic cholecystitis is the constant swelling of the gallbladder most often caused by gallstones. The most common symptom is severe pain near the bottom of the ribs on the right side. In most people, the gallbladder can be removed without serious side effects. If there are frequent severe attacks of pain, it is rated 30%. If there is heartburn and occasional attacks of severe pain, it is rated 10%. If there are only occasional mild symptoms, it is rated 0%.

Code 7315: Chronic cholelithiasis is the regular production of hard stones in the gallbladder, which can lead to swelling, pain, and other diseases and infections. This condition is rated as chronic cholecystitis under code 7314. The final code would look like this: 7315-7314. The first four-digit code defines it as cholelithiasis, and the second four-digit code tells how it is rated.

Code 7316: Chronic cholangitis is an infection of the tube that takes the bile from the liver to the gallbladder. This condition is rated as chronic cholecystitis under code 7314. The final code would look like this: 7316-7314. The first four-digit code defines it as cholangitis, and the second four-digit code tells how it is rated.

Code 7317: Any lasting symptoms after an injury to the gallbladder are rated as peritoneal adhesions. The final code would look like this: 7317-7301. The first four-digit code defines it as a gallbladder injury, and the second four-digit code tells how it is rated.

Code 7318: The removal of the gallbladder normally does not cause any serious side effects, but complications are always possible. If the removal of the gallbladder causes severe symptoms, like pain and nausea, it is rated 30%. If there are only mild symptoms, it is rated 10%. If there are no symptoms, it is rated 0%.

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The Liver and Hepatitis

The liver is essential to the functioning of the body. It regulates the metabolism, clears out old red blood cells, produces hormones and cleans toxins out of the body. It also produces bile which is key to digesting fats.

Code 7312: Cirrhosis of the liver, primary biliary cirrhosis, and the cirrhotic phase of sclerosing cholangitis are all rated under this code. For any of these conditions to qualify for a rating, proper tests like a biopsy and liver function test must be performed.

If the condition causes weakness, significant weight loss, and continuous jaundice, or if there is one or more of the following that cannot be fixed by treatment: 1) swelling in the abdomen, 2) mental disturbances like confusion, loss of consciousness and coma, or 3) bleeding in the abdomen from the blood vessels or portal gastropathy, it is rated 100%.

If the condition has caused 2 or more episodes of swelling in the abdomen, mental disturbances, or bleeding in the abdomen with periods in between these episodes where the disease is not active, it is rated 70%. If the condition has caused 1 episode of swelling in the abdomen, mental disturbances, or bleeding in the abdomen, it is rated 50%. If there is high blood pressure in the portal vein and swelling in the spleen with weakness, anorexia, stomach pain, uneasiness, and minor weight loss, it is rated 30%. If there are symptoms like weakness, anorexia, stomach pain and uneasiness, it is rated 10%.

Code 7345: Any chronic liver disease that doesn’t have cirrhosis is rated under this code. This includes diseases like Hepatitis B, chronic active hepatitis, autoimmune hepatitis, hemochromatosis, drug-induced hepatitis, and others. Hepatitis C and bile duct disorders are not rated here.

Note: If there are two different conditions and one rates under this code and another rates as Hepatitis C under code 7354, then the symptoms caused the by condition rated under code 7354 cannot count towards another rating under this code.

If there are near-constant, completely disabling symptoms like fatigue, uneasiness, vomiting, anorexia, joint pain, and pain in the upper right abdomen, it is rated 100%. If there is significant fatigue, uneasiness, anorexia with significant weight loss or malnutrition, and swelling in the liver, or incapacitating episodes totaling 6 weeks or more in the past year that include symptoms like fatigue, uneasiness, nausea, vomiting, anorexia, joint pain and pain in the upper right abdomen, it is rated 60%.

If there is significant fatigue, uneasiness, anorexia with weight loss and swelling in the liver, or if there are incapacitating episodes totaling 4 to 6 weeks in the past year that include symptoms like fatigue, uneasiness, nausea, vomiting, anorexia, joint pain, and pain in the upper right abdomen, it is rated 40%.

If there is significant fatigue, uneasiness and anorexia (without weight loss) that requires either a special diet or constant medication, or if there are incapacitating episodes totaling 2 to 4 weeks in the past year that include symptoms like fatigue, uneasiness, nausea, vomiting, anorexia, joint pain, and pain in the upper right abdomen, it is rated 20%.

If there is occasional fatigue, uneasiness and anorexia, or if there are incapacitating episodes totaling 1 to 2 weeks in the past year that include symptoms like fatigue, uneasiness, nausea, vomiting, anorexia, joint pain, and pain in the upper right abdomen, it is rated 10%.

If the condition does not have any symptoms, it is rated 0%.

Code 7351: If a liver transplant is performed, it is rated 100%. This 100% rating continues for 1 year following the surgery. The condition is then re-evaluated, and the main residual symptom or complication is rated. Only one rating can be given for a liver transplant and its residuals. Rate the residual that would give the highest rating. The minimum rating for a liver transplant is 30%.

Code 7354: Hepatitis C or any hepatitis that is not A or B can be rated under this code. Hepatitis C is an infection in the liver that most often does not show any symptoms. A worse case of hepatitis C can, however, lead to cirrhosis, liver cancer, and liver failure. For this condition to qualify for a rating, its presence must be proved by a serologic test.

Note: If there are two different conditions and one rates under this code and another rates under, say 7345, then the symptoms caused the by condition rated under this code cannot count towards another rating under code 7345.

If there is near-constant, completely disabling symptoms like fatigue, uneasiness, vomiting, anorexia, joint pain, and pain in the upper right abdomen, it is rated 100%. If there is significant fatigue, uneasiness, anorexia with significant weight loss or malnutrition, and swelling in the liver, or incapacitating episodes totaling 6 weeks or more in the past year that include symptoms like fatigue, uneasiness, nausea, vomiting, anorexia, joint pain and pain in the upper right abdomen, it is rated 60%.

If there is significant fatigue, uneasiness, anorexia with weight loss and swelling in the liver, or if there are incapacitating episodes totaling 4 to 6 weeks in the past year that include symptoms like fatigue, uneasiness, nausea, vomiting, anorexia, joint pain, and pain in the upper right abdomen, it is rated 40%.

If there is significant fatigue, uneasiness and anorexia (without weight loss) that requires either a special diet or constant medication, or if there are incapacitating episodes totaling 2 to 4 weeks in the past year that include symptoms like fatigue, uneasiness, nausea, vomiting, anorexia, joint pain, and pain in the upper right abdomen, it is rated 20%.

If there is occasional fatigue, uneasiness and anorexia, or if there are incapacitating episodes totaling 1 to 2 weeks in the past year that include symptoms like fatigue, uneasiness, nausea, vomiting, anorexia, joint pain, and pain in the upper right abdomen, it is rated 10%.

If the condition does not have any symptoms, it is rated 0%.

Code 7311: Any lasting symptoms after an injury to the liver are rated either as peritoneal adhesions, cirrhosis, or chronic liver disease whichever best defines the symptoms and gives the highest rating. The final code would look like this: 7311-7312. The first four-digit code defines it as a liver injury, and the second four-digit code tells how it is rated.

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The Intestines (Colon)

First thing first. There are only two intestines: the small intestine and the large intestine. So what the heck is the colon???!!!!

The “colon” is the large intestine. Not completely sure why they needed another name for it, but there it is. It is important to note that the “colon” is divided into three sections, all of which are just sections of the large intestine. They will never be referred to, however, as the three sections of the large intestine. So, to simplify things, we are just going to refer to the entire large intestine as the colon.

So, there are two intestines: the small intestine and the colon. The small intestine receives food directly from the stomach. It then pushes the food down its length, absorbing nutrients as it goes. The left over food is then emptied into the colon where the water in the food is absorbed. The rest of the waste is then formed into feces and passed on to the rectum.

Code 7319: Irritable colon syndrome (a.k.a. irritable bowel syndrome, spastic colitis, mucous colitis, etc.) is a condition where there is significant stomach pain, bloating and often changes in the pattern of bowel movements with diarrhea or constipation. There is no known cause of this condition.

If it is severe with diarrhea, or if it alternates between diarrhea and constipation, with stomach pains, it is rated 30%. If there are frequent episodes of abnormal bowel movements with stomach pain, it is rated 10%. If there are mild abnormal bowel movements with occasional stomach pain, it is rated 0%.

Code 7325: Chronic enteritis is the constant swelling of the small intestine. Symptoms include stomach pain, cramping, diarrhea, dehydration and fever. It is rated as irritable colon syndrome, code 7319 above. The final code for this condition will look like this: 7325-7319. The first four-digit code defines the condition as enteritis, and the second four-digit code tells how it is rated.

Code 7326: Chronic enterocolitis is the constant swelling of the colon and small intestine. It is rated as irritable colon syndrome. The final code for this condition will look like this: 7326-7319. The first four-digit code defines the condition as enterocolitis, and the second four-digit code tells how it is rated.

Code 7323: Ulcerative colitis (a.k.a. inflammatory bowel disease) is a disease of the colon where tears or open sores form in the tissues of the colon and cause bloody diarrhea.

If it is very severe and constant and causes serious malnutrition, anemia, and overall disabling bad health or if it causes a severe liver abscess, it is rated 100%. If it is severe, but not constant, with many attacks a year that cause malnutrition which then causes overall bad health that cannot be fully recovered during the periods in between attacks, it is rated 60%. If it is somewhat severe and causes some attacks a year, but less than a severe condition, it is rated 30%. If there are only occasional attacks, it is rated 10%.

Code 7322: Bacillary dysentery (a.k.a. Marlow Syndrome and severe Shigellosis) is an infectious bacteria that causes the intestines to swell, particularly the colon. It causes bloody diarrhea, fever, and stomach pain. It can be treated and lasts only about a week, but can be fatal if left untreated. This condition is rated as ulcerative colitis, code 7323 above. The final code for this condition will look like this: 7322-7323. The first four-digit code defines the condition as bacillary dysentery and the second four-digit code tells how it is rated.

Code 7321: Amebiasis is a serious infection that can cause diarrhea, dysentery and even death. If it causes a lung abscess, it is rated under code 6824. Otherwise, amebiasis is rated as ulcerative colitis. The final code for this condition will look like this: 7321-6824. The first four-digit code defines the condition as amebiasis, and the second four-digit code tells how it is rated.

A key for this code: Regardless if this condition is rated under 6809 or 7323 and what those codes say are the requirements for a 10% and 0% rating, the 10% and 0% ratings are described as follows. If there are low stomach cramps, nausea, bloating, and continuous constipation with diarrhea on occasion, it is rated 10%. If there are no symptoms at all, it is rated 0%.

Code 7327: Diverticulitis is a disease of the colon that causes pouches outside the colon to form and then swell. It can cause fever, pain, nausea, diarrhea and high white blood cell count. It is either rated as irritable colon syndrome, peritoneal adhesions, or ulcerative colitis, whichever most closely describes the overall condition and symptoms.

Code 7324: Distomiasis is an infection that can affect the liver or the intestine. If it causes severe symptoms like fever, pain, diarrhea, dehydration and overall disabling health, it is rated 30%. If the symptoms moderately affect the overall health, it is rated 10%. With mild or no symptoms, it is rated 0%.

Code 7328: A resection of the small intestine is a procedure where all or a part of the intestine is removed. If the small intestine can no longer absorb enough nutrients to sustain the body, causing the overall health of the body to seriously decline (significant weight loss, serious nutritional deficiencies, etc.), it is rated 60%. If the small intestine can still absorb some nutrients, but not enough to maintain a healthy weight, it is rated 40%. If the small intestine can absorb enough nutrients, but there is diarrhea, anemia, and the inability to gain weight, it is rated 20%.

Code 7329: A resection of the large intestine is a procedure where all or a part of the intestine is removed. If the procedure causes severe symptoms, like the inability to pass feces or constant dehydration, that significantly affect the overall health, it is rated 40%. If is causes definite symptoms, like regular diarrhea and the need to drink more water than normal, it is rated 20%. If there are only mild symptoms, like increased thirst, it is rated 10%. If the symptoms are only caused by scar tissue from the procedure, the entire condition is rated under code 7301.

Code 7330: A fistula of the intestine (large or small intestine), is an abnormal passageway from the intestine to another organ or to the outside of the body. If surgery was attempted to repair the fistula, but the surgery was not fully successful or the fistula re-developed, it is ratable under this code. If the surgery successfully repaired it, then it is rated under code 7301.

If a very large amount of feces frequently moves through the fistula, it is rated 100%. If feces constantly or frequently move through the fistula, it is rated 60%. If a small amount of feces move through the fistula every now and then, it is rated 30%.

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The Rectum and Anus

The rectum is the very end of the colon (large intestine), and acts as a storage area for feces before pushing the feces through the anus to exit the body.

Code 7332: Poor sphincter control occurs when the sphincter muscle, a muscle that encircles the opening of the rectum and anus, cannot contract properly or be controlled, thus leading to feces exiting the body at unwanted times. This is also known as incontinence.

If there is no sphincter control at all, it is rated 100%. If there is a significant amount of stuff always leaking out of the anus and frequent uncontrollable bowel movements, it is rated 60%. If there are only occasional uncontrollable bowel movements that require a pad or other materials to be worn, it is rated 30%. If there are not any uncontrollable bowel movements, but there is constant slight leakage or occasional moderate leakage, it is rated 10%. If there is no leakage at all, it is rated 0%.

If there is a loss of sphincter control and both legs are amputated or paralyzed, then a rating of 100% is always given, regardless of improvement with therapy. This is also the case if the loss of sphincter control is due to a spinal cord disease or injury.

Code 7335: An anal fistula (or “fistula-in-ano”) is an abnormal passageway that connects the anus to other parts of the body or to an abnormal opening in the skin. This condition is rated as loss of sphincter control. The final code for this condition will look like this: 7335-7332. The first four-digit code defines the condition as an anal fistula, and the second four-digit code tells how it is rated.

Code 7333: A stricture of the rectum or anus is a patch of scar tissue that narrows the openings of the rectum and anus, thus making it difficult or impossible for feces to pass through. If a colostomy, a surgical procedure that creates a new passageway from the rectum or anus to the outside of the body, is required, it is rated 100%. If the scar tissue seriously decreases the space in the rectum or anus, or if there is extensive leakage, it is rated 50%. If the scar tissue only moderately decreases the space in the rectum or anus, or if there is moderate but constant leakage, it is rated 30%.

Code 7334: A prolapse of the rectum occurs when the muscles or tissues holding the rectum in place weaken and the rectum slips out of place and can slip down out of the anus. If the rectum is completely out of the anus and stays out, it is rated 50%. If it doesn’t slip all the way out, but it stays out or slips out frequently, it is rated 30%. If it is only a little out of place and doesn’t slip out of the anus, but does cause leakage, it is rated 10%.

Code 7336: Hemorrhoids are swollen veins inside or outside the body near the anus. They are created from a lot of pressure being used to pass feces and can be very painful. If the hemorrhoids cause constant bleeding that leads to significant blood loss and anemia, a decrease in the number of red blood cells, or if they cause fissures, it is rated 20%. If there are blood clots inside the swollen veins, the swelling can’t go down, and there is a lot of redundant tissue, it is rated 10%. If they are only moderate with occasional bleeding, it is rated 0%.

Code 7337: Pruritus ani is seriously itchy skin around the anus. This condition never develops by itself but is always a symptom of another condition. Because of that, the condition causing the itching is ratable, but the itching alone is not.

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The Abdomen and Peritoneum

The abdomen is the large cavity in which all the organs sit. It stretches from the hip bones all the way to the diaphragm, a large tissue that separates the abdominal cavity from the cavity where the lungs and heart sit. The peritoneum is the tissue that lines the entire abdomen just under the skin.

Code 7301: Adhesions of the peritoneum are areas of scar tissue that cause the surface of the peritoneum to stick to the surface of organs. This can cause the organs to twist out of shape and thus function poorly. Adhesions are only ratable if abdominal surgeries have been performed or if injury or an infectious disease has affected the inside of the abdomen, and if two or more of the following is present: 1) a slowing down of digestive functioning, 2) the digestive tract is partially or completely blocked, 3) acid and fluids in the digestive tract come up into the esophagus (reflux), and 4) pain.

If the adhesions develop after a ruptured appendix, an ulcer that burns the peritoneum, or a surgery that required drainage out of the abdomen, and they cause the digestive path to become partially blocked, with frequent episodes of swelling and pressure in the abdomen, and nausea or vomiting, it is rated 50%.

If the adhesions cause the digestive path to become partially blocked, and it is proven by a barium meal test, and there are only occasional episodes of pain, it is rated 30%.

If there is tight pain when moving the abdomen (it feels like something is pulling inside), or if there are occasional episodes of swelling, bloating, nausea, and constipation, it is rated 10%.

If the condition is mild with few symptoms, it is rated 0%.

Code 7331: Tuberculosis of the peritoneum is rated 100% while active. Once the condition is inactive, the 100% rating will continue for 1 year. After that the condition is rated on any lasting symptoms or residuals. For example, if the large intestine was affected by the tuberculosis and continues to have problems functioning correctly, the large intestine would be rated under the code that most closely describes the condition. The final code for this condition would look like this: 7331-7323. The first four-digit code defines the condition as tuberculosis of the peritoneum, and the second four-digit code tells how it is rated.

Code 7342: Visceroptosis occurs when all the organs in the abdomen sink down out of their proper places. If it causes any symptoms, it is rated 10%.

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Ulcers

Ulcers are tears or breaks in the tissues. They can occur in any part of the body, are painful, and can cause the organs they affect to not function properly.

Note: It is vital that the doctor performing the exam clearly describe the exact location and symptoms of the ulcer. The term “peptic ulcer” is not specific enough to get a proper rating, since it could describe an ulcer in many different locations, each of which will show different symptoms.

Both code 7304 and 7305 are rated by the same rating system.

Code 7304: A gastric ulcer is an ulcer in the stomach.

Code 7305: A duodenal ulcer is an ulcer in the lower part of the stomach and beginning of the small intestine (the duodenum).

The ratings:

If the pain cannot be fully relieved by treatment, there is occasional vomiting, blood in the vomit or in the feces, anemia, weight loss and an overall serious decline in health, it is rated 60%. If there is a definite decrease in overall health with anemia and weight loss, or if there are repeated periods of required bed rest prescribed by a physician that average about 10 days or more at least 4 or more times a year, it is rated 40%. If there are repeated periods of severe symptoms that average about 10 days or more 2 or 3 times a year, or if there are constant moderate symptoms, it is rated 20%. If it is mild with episodes of symptoms once or twice a year, it is rated 10%.

Code 7306: A marginal ulcer in both the stomach and the small intestine is an ulcer caused by healthy cells dying.

If there is constant or periodic severe pain that cannot be relieved by treatment, occasional vomiting, blood in the vomit or feces, and weight loss that is completely disabling, it is rated 100%. If the same symptoms are present, but they are less frequent or severe and cause a serious but not complete disability, it is rated 60%. If there are episodes at least once a month that can be partially or completely relieved by treatment of vomiting, pain or blood in the feces, it is rated 40%. If there are moderate episodes several times a year, it is rated 20%. If there are mild or short episodes once or twice a year, it is rated 10%.

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Hernias

A hernia is a whole in the wall and muscles of the cavity that allows organs to push through it.

Code 7338: An inguinal hernia is a hernia in the hole in the inguinal canal that allows the organs in the abdomen fall into the inguinal canal.

If a surgery was performed to fix a large hernia, but it re-herniated and another surgery cannot be performed, it is rated 60%. If a surgery was performed to fix a small hernia, but it re-herniated, or if it cannot be fixed at all, it is rated 30%. If a surgery was performed to fix the hernia, it re-herniated, but it is treatable and can be supported by a belt, it is rated 10%. If a surgery was not performed, but it is treatable, or if it is small and no organs are pushing through the hole, it is rated 0%.

Note: There are two inguinal canals, and so both can herniate. If they do, and both qualify for a rating, then the most severe of the two is rated on the requirements above, and then 10% is added for the second hernia. Both do not get full ratings. So, if one is rated 30%, and the other can also be rated 30%, only 10% can be given for the second. The two conditions are then combined to be one hernia condition. The total rating for the one hernia condition in this case would be 40% (30% + 10% = 40% for one total hernia condition).

Code 7340: A femoral hernia occurs when the abdominal organs push through the femoral canal at the top of the thigh near the groin. This condition is rated as an inguinal hernia.

Code 7339: A ventral hernia occurs when the abdominal organs push through a part of the abdominal wall. This condition is easily treated by surgery. If surgery has been performed, but there are still problems, the condition can then be rated on the following criteria.

If the hernia is really big, with a severe separation of the abdominal muscles, a destruction of the abdominal muscles over a large area, or with severe weakening of the muscles and tissues so that surgery would not be able to fix it, it is rated 100%. If the hernia is large and cannot be supported by a belt or brace, it is rated 40%. If it is small and cannot be supported by a belt or brace, or if the surgery worked and the wounds healed, but they are weak and need support by a belt or brace, it is rated 20%. If the surgery worked and the wounds healed well, it is rated 0%.

Code 7346: A hiatal hernia is a hernia in the diaphragm that allows the organs in the abdomen to move up into the chest cavity.

If the hernia causes pain, vomiting, significant weight loss, blood in the vomit or feces, and anemia, or if other symptoms cause a serious overall health disability, it is rated 60%. If there are regular episodes of pain in the upper abdomen, trouble swallowing, heartburn, the return of food into the back of the throat/mouth, and pain in the upper arm or shoulder, it is rated 30%. If two or more of the previous symptoms are present, but are not as severe, it is rated 10%.

For any other kind of muscle hernias, please see code 5326 on the Muscle Hernias page.

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Cancer and Tumors of the Digestive System

Cancer and tumors are made up of the growth of abnormal cells. These cells can be benign—they do not attack the good cells around them (tumors)—or they can be malignant—they attack the cells around them (cancers). A “cancerous tumor” is just cancer under our definition.

Code 7343: Any malignant cancer of the digestive system is rated 100% while it is active. This 100% rating continues for 6 months following the last treatment. The condition is then reevaluated and any left over symptoms or complications are rated separately.

Code 7344: Any tumor of the digestive system is rated on any systems or functions that it affects. For example, if the tumor pushes on the small intestine and makes it hard for things to move through it, then the obstruction of the small intestine would be rated.

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Other Digestive Conditions

All other digestive system conditions will be rated analogously (see the Analogous and Equivalent Codes page) with the above ratings. The bottom line rule is to rate any condition under the code that BEST describes it, even if it is not exact.

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DBQs for Digestive Conditions

Here are the Disability Benefits Questionnaires (DBQs) used for digestive conditions: Mouth, Lips, and Tongue DBQ, Esophageal Conditions DBQ, Gallbladder and Pancreas DBQ, Intestinal Surgery DBQ, Liver and Hepatits DBQ, Peritoneal Adhesions DBQ, Stomach and Duodenal DBQ, Infectious Intestinal Disorders DBQ, Hernias DBQ, Rectum and Anus DBQ, and Intestinal Conditions DBQ.

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Principles that Apply

Probative Value: If two exams record the condition differently, the exam with the most thorough data and performed by the most qualified person in that specialty will be the exam the rating is based on.

Pyramiding: A single condition can only be rated once! However, if another condition exists that is additional to the digestive system condition (not simply caused by it), then it can also be rated.

A Tie Goes to the Veteran: If there are two equally strong exams with conflicting information, or if the condition can be equally rated under two different codes, then the one that gives the highest rating will be assigned. Every conflict should be resolved in favor of the higher rating.

Accurate Measurements: It is essential that the necessary information to rate your condition is recorded by the physician in your exam. With the information on this page, you should know what needs to be measured and recorded. Make sure this happens correctly to ensure that you receive a proper rating.

Hospital or Convalescent Ratings: Some conditions require periods of hospitalization or constant medical care (at-home nurse, etc.). Any condition that requires this is rated 100% during this intensive treatment. Once it ends, then the 100% rating will continue for a certain period. This period is 3 months unless another length (6 months, 1 year, etc.) is directly specified in the condition ratings. Some patients may need more time to recover than others, so the physician or Rating Authorities can lengthen this time period if they see fit.

Please see the VASRD Principles page for further guidance.

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