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54086

Federal Register / Vol. 86, No. 187 / Thursday, September 30, 2021 / Rules and Regulations
areas. Where diagnostic codes refer the decision maker to these specific areas of dysfunction, only the predominant area of dysfunction shall be considered for rating purposes. Distinct disabilities
may be evaluated separately under this section, pursuant to 4.14, if the symptoms do not overlap. Since the areas of dysfunction described below do not cover all symptoms resulting from
genitourinary diseases, specific diagnoses may include a description of symptoms assigned to that diagnosis.

Rating Renal dysfunction:
Chronic kidney disease with glomerular filtration rate GFR less than 15 mL/min/1.73 m2 for at least 3 consecutive months during the past 12 months; or requiring regular routine dialysis; or eligible kidney transplant recipient
Chronic kidney disease with GFR from 15 to 29 mL/min/1.73 m2 for at least 3 consecutive months during the past 12
months
Chronic kidney disease with GFR from 30 to 44 mL/min/1.73 m2 for at least 3 consecutive months during the past 12
months
Chronic kidney disease with GFR from 45 to 59 mL/min/1.73 m2 for at least 3 consecutive months during the past 12
months
GFR from 60 to 89 mL/min/1.73 m2 and either recurrent red blood cell RBC casts, white blood cell WBC casts, or granular casts for at least 3 consecutive months during the past 12 months; or GFR from 60 to 89 mL/min/1.73 m2 and structural kidney abnormalities cystic, obstructive, or glomerular for at least 3
consecutive months during the past 12 months; or GFR from 60 to 89 mL/min/1.73 m2 and albumin/creatinine ratio ACR 30 mg/g for at least 3 consecutive months during the past 12 months
Note: GFR, estimated GFR eGFR, and creatinine-based approximations of GFR will be accepted for evaluation purposes under this section when determined to be appropriate and calculated by a medical professional.

Urinary tract infection:
Poor renal function: Rate as renal dysfunction.
Recurrent symptomatic infection requiring drainage by stent or nephrostomy tube; or requiring greater than 2 hospitalizations per year; or requiring continuous intensive management
Recurrent symptomatic infection requiring 12 hospitalizations per year or suppressive drug therapy lasting six months or longer
Recurrent symptomatic infection not requiring hospitalization, but requiring suppressive drug therapy for less than 6 months
3. Amend 4.115b by:
a. Revising the entry for diagnostic code 7508;
b. Removing the entry for diagnostic code 7510;
c. Revising the entries for diagnostic codes 7520, 7521, 7522, 7524, 7525,

7527, 7533, 7534, 7537, 7539, 7541, and 7542; and d. Adding entries in numerical order for diagnostic codes 7543, 7544, and 7545.

100
80
60
30

0

30
10
0

The revisions and additions read as follows:
4.115b Ratings of the genitourinary systemdiagnoses.

LOTTER on DSK11XQN23PROD with RULES1

Rating

7508 Nephrolithiasis/Ureterolithiasis/Nephrocalcinosis:
Rate as hydronephrosis, except for recurrent stone formation requiring invasive or non-invasive procedures more than two times/year

7520 Penis, removal of half or more
7521 Penis, removal of glans
7522 Erectile dysfunction, with or without penile deformity
Note: For the purpose of VA disability evaluation, a disease or traumatic injury of the penis resulting in scarring or deformity shall be rated under diagnostic code 7522.

7524 Testis, removal:
Both
One
Note: In cases of the removal of one testis as the result of a service-incurred injury or disease, other than an undescended or congenitally undeveloped testis, with the absence or nonfunctioning of the other testis unrelated to service, an evaluation of 30 percent will be assigned for the service-connected testicular loss. Testis, undescended, or congenitally undeveloped is not a ratable disability.
7525 Prostatitis, urethritis, epididymitis, orchitis unilateral or bilateral, chronic only:
Rate as urinary tract infection.
For tubercular infections: Rate in accordance with 4.88b or 4.89, whichever is appropriate.
7527 Prostate gland injuries, infections, hypertrophy, postoperative residuals, bladder outlet obstruction:
Rate as voiding dysfunction or urinary tract infection, whichever is predominant.

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