Federal Register - September 30, 2021
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Source: Federal Register
54094
Federal Register / Vol. 86, No. 187 / Thursday, September 30, 2021 / Rules and Regulations DISEASES OF THE HEARTContinued Unless otherwise directed, use this general rating formula to evaluate diseases of the heart.
Rating
LOTTER on DSK11XQN23PROD with RULES1
Thereafter, use the General Rating Formula.
7007 Hypertensive heart disease.
7008 Hyperthyroid heart disease:
Rate under the appropriate cardiovascular diagnostic code, depending on particular findings.
For DCs 7009, 7010, 7011, and 7015, a single evaluation will be assigned under the diagnostic code that reflects the predominant disability picture.
7009 Bradycardia Bradyarrhythmia, symptomatic, requiring permanent pacemaker implantation:
For one month following hospital discharge for implantation or re-implantation
Thereafter, use the General Rating Formula.
Note 1: Bradycardia bradyarrhythmia refers to conduction abnormalities that produce a heart rate less than 60 beats/min.
There are five general classes of bradyarrhythmia: Sinus bradycardia, including sinoatrial block; atrioventricular AV
junctional nodal escape rhythm; AV heart block second or third degree or AV dissociation; atrial fibrillation or flutter with a slow ventricular response; and, idioventricular escape rhythm.
Note 2: Asymptomatic bradycardia bradyarrhythmia is a medical finding only. It is not a disability subject to compensation.
7010 Supraventricular tachycardia:
Confirmed by ECG, with five or more treatment interventions per year
Confirmed by ECG, with one to four treatment interventions per year; or, confirmed by ECG with either continuous use of oral medications to control or use of vagal maneuvers to control
Note 1: Examples of supraventricular tachycardia include, but are not limited to: Atrial fibrillation, atrial flutter, sinus tachycardia, sinoatrial nodal reentrant tachycardia, atrioventricular nodal reentrant tachycardia, atrioventricular reentrant tachycardia, atrial tachycardia, junctional tachycardia, and multifocal atrial tachycardia.
Note 2: For the purposes of this diagnostic code, a treatment intervention occurs whenever a symptomatic patient requires intravenous pharmacologic adjustment, cardioversion, and/or ablation for symptom relief.
7011 Ventricular arrhythmias sustained:
For an indefinite period from the date of inpatient hospital admission for initial medical therapy for a sustained ventricular arrhythmia; or, for an indefinite period from the date of inpatient hospital admission for ventricular aneurysmectomy; or, with an automatic implantable cardioverter-defibrillator AICD in place
Note: When inpatient hospitalization for sustained ventricular arrhythmia or ventricular aneurysmectomy is required, a 100-percent evaluation begins on the date of hospital admission with a mandatory VA examination six months following hospital discharge. Evaluate post-surgical residuals under the General Rating Formula. Apply the provisions of 3.105e of this chapter to any change in evaluation based upon that or any subsequent examination.
7015 Atrioventricular block:
Benign First-Degree and Second-Degree, Type I:
Evaluate under the General Rating Formula.
Non-Benign Second-Degree, Type II and Third-Degree:
Evaluate under DC 7018 implantable cardiac pacemakers.
7016 Heart valve replacement prosthesis:
For an indefinite period following date of hospital admission for valve replacement
Thereafter, use the General Rating Formula.
Note: Six months following discharge from inpatient hospitalization, disability evaluation shall be conducted by mandatory VA
examination using the General Rating Formula. Apply the provisions of 3.105e of this chapter to any change in evaluation based upon that or any subsequent examination.
7017 Coronary bypass surgery:
For three months following hospital admission for surgery
Thereafter, use the General Rating Formula.
7018 Implantable cardiac pacemakers:
For one month following hospital discharge for implantation or re-implantation
Thereafter:
Evaluate as supraventricular tachycardia DC 7010, ventricular arrhythmias DC 7011, or atrioventricular block DC
7015.
Minimum
Note: Evaluate automatic implantable cardioverter-defibrillators AICDs under DC 7011.
7019 Cardiac transplantation:
For a minimum of one year from the date of hospital admission for cardiac transplantation
Thereafter:
Evaluate under the General Rating Formula.
Minimum
Note: One year following discharge from inpatient hospitalization, determine the appropriate disability rating by mandatory VA
examination. Apply the provisions of 3.105e of this chapter to any change in evaluation based upon that or any subsequent examination.
7020 Cardiomyopathy.
100
30
10
100
100
100
100
10
100
30
DISEASES OF THE ARTERIES AND VEINS
7110 Aortic aneurysm: Ascending, thoracic, or abdominal:
Evaluate at 100 percent if the aneurysm is any one of the following: Five centimeters or larger in diameter; symptomatic e.g., precludes exertion; or requires surgery
Otherwise
Evaluate non-cardiovascular residuals of surgical correction according to organ systems affected.
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