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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

7122 Cold injury residuals:
With the following in affected parts:
Arthralgia or other pain, numbness, or cold sensitivity plus two or more of the following: Tissue loss, nail abnormalities, color changes, locally impaired sensation, hyperhidrosis, anhydrosis, X-ray abnormalities osteoporosis, subarticular punched-out lesions, or osteoarthritis, atrophy or fibrosis of the affected musculature, flexion or extension deformity of distal joints, volar fat pad loss in fingers or toes, avascular necrosis of bone, chronic ulceration, carpal or tarsal tunnel syndrome
Arthralgia or other pain, numbness, or cold sensitivity plus one of the following: Tissue loss, nail abnormalities, color changes, locally impaired sensation, hyperhidrosis, anhydrosis, X-ray abnormalities osteoporosis, subarticular punched-out lesions, or osteoarthritis, atrophy or fibrosis of the affected musculature, flexion or extension deformity of distal joints, volar fat pad loss in fingers or toes, avascular necrosis of bone, chronic ulceration, carpal or tarsal tunnel syndrome
Arthralgia or other pain, numbness, or cold sensitivity
Note 1: Separately evaluate amputations of fingers or toes, and complications such as squamous cell carcinoma at the site of a cold injury scar or peripheral neuropathy, under other diagnostic codes. Separately evaluate other disabilities diagnosed as the residual effects of cold injury, such as Raynauds syndrome which is otherwise known as secondary Raynauds phenomenon, muscle atrophy, etc., unless they are used to support an evaluation under diagnostic code 7122.
Note 2: Evaluate each affected part e.g., hand, foot, ear, nose separately and combine the ratings in accordance with 4.25 and 4.26.

7124 Raynauds disease also known as primary Raynauds:
Characteristic attacks associated with trophic changes, such as tight, shiny skin
Characteristic attacks without trophic changes
Note 1: For purposes of this section, characteristic attacks consist of intermittent and episodic color changes of the digits of one or more extremities, lasting minutes or longer, with occasional pain and paresthesias, and precipitated by exposure to cold or by emotional upsets. These evaluations are for the disease as a whole, regardless of the number of extremities involved or whether the nose and ears are involved.
Note 2: Trophic changes include, but are not limited to, skin changes thinning, atrophy, fissuring, ulceration, scarring, absence of hair as well as nail changes clubbing, deformities.
Note 3: This section is for evaluating Raynauds disease primary Raynauds. For evaluation of Raynauds syndrome also known as secondary Raynauds phenomenon, or secondary Raynauds, see DC 7117.

4. Amend appendix A to part 4 under 4.104 by:
a. Adding an entry for General Rating Formula for Diseases of the Heart above the entry for diagnostic code 7000;

Sec.

Diagnostic code No.

4.104

7000

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e. Adding in numerical order an entry for DC 7124.
The additions and revisions read as follows:

Appendix A to Part 4Table of Amendments and Effective Dates Since 1946

7006
7007
7008
7009
7010
7011

General Rating Formula for Diseases of the Heart November 14, 2021.
Evaluation July 6, 1950; evaluation September 22, 1978, evaluation January 12, 1998; criterion November 14, 2021.
Evaluation January 12, 1998; criterion November 14, 2021.
Evaluation January 12, 1998; criterion November 14, 2021.
Evaluation January 12, 1998; criterion November 14, 2021.
Criterion September 22, 1978; evaluation January 12, 1998; criterion November 14, 2021.
Evaluation September 9, 1975; evaluation September 22, 1978; evaluation January 12, 1998; criterion November 14, 2021.
Evaluation January 12, 1998; criterion November 14, 2021.
Evaluation September 22, 1978; evaluation January 12, 1998; criterion November 14, 2021.
Evaluation January 12, 1998; criterion December 10, 2017; evaluation November 14, 2021.
Added November 14, 2021.
Evaluation January 12, 1998; title, criterion November 14, 2021.
Evaluation January 12, 1998; note, criterion November 14, 2021.

7015
7016
7017

Evaluation September 9, 1975; criterion January 12, 1998; criterion November 14, 2021.
Added September 9, 1975; criterion January 12, 1998; note, criterion November 14, 2021.
Added September 22, 1978; evaluation January 12, 1998; criterion November 14, 2021.

7001
7002
7003
7004
7005

b. Revising the entries for DCs 7000
through 7008;
c. Adding in numerical order an entry for DC 7009;
d. Revising the entries for DCs 7010, 7011, 7015 through 7020, 7110, 7111, 7113 through 7115, 7117, 7120, and 7122; and

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