Artery and Vein Conditions
Including Cold Injuries, Aneurysms, Arteriovenous Fistula, Blood Flow Restrictions and Blocks, Raynaud’s Syndrome, Erythromelalgia, Severe Allergic Swelling, Sarcoma of the blood vessels
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Aneurysms
An aneurysm occurs when an artery swells to 1.5 or more times its normal size. It is usually a sign of weakness in the tissues of the artery.
Code 7110: If an aneurysm in the aortic artery is corrected by surgery, then it is rated 100% from the day of admittance to the hospital. This rating continues for the first 6 months after discharge from the hospital. The condition is then reevaluated and rated accordingly. If the condition is active and causes symptoms such as pain or hemorrhaging, or if it is 5 centimeters or larger in diameter, then it is rated 100%. If the condition is serious enough that you cannot perform moderately strenuous activities (lifting weights or running), then it is rated 60%. If the condition does not qualify for these ratings, then it is rated based on the existing symptoms in the affected organ (e.g. if it caused erratic heart beats, then it would be rated as arrhythmia).
Code 7111: If an aneurysm in any large artery is surgically corrected, then it is rated 100% from the date of admission to the hospital. This rating continues for the first 6 months after discharge from the hospital. The condition is then reevaluated and rated accordingly. A 100% rating is given if there is pain in the limbs (claudication) and tears in the skin of the limbs from lack of oxygen or if there is pain in the limbs and the ankle brachial index is 0.4 or less.
A 60% rating is given if you cannot walk further than 25 yards without limping because of pain and one or more of the following: there is coldness in the limb that does not respond to warming methods, there are one or more tears in the skin of the limb, or the ankle brachial index is 0.5 or less.
A 40% rating is given if you have limping because of pain when walking between 25 and 100 yards and one or more of the following: there are
1.) changes to the hair, skin, or nails of the affected limb, or
2.) the ankle brachial index is 0.7 or less.
A 20% rating is given if you have limping because of pain when walking more than 100 yards and one or more of the following: the pulse in the limb is diminished, or the ankle brachial index is 0.9 or less.
Note: These ratings are for a single limb only. If more than one limb has an aneurysm, then rate each separately.
Code 7112: An aneurysm in any small artery rates 0% if there are no symptoms. If there are symptoms, then the body part or system affected is rated. So if there is an aneurysm in a small artery of the leg that causes pain and a limited range of motion, then it would be rated on that limitation of motion.
Arteriovenous Fistula
Code 7113: A traumatic arteriovenous fistula is an abnormal passageway between an artery and a vein. They are most often caused by penetrating wounds that affected nearby arteries or veins, thus causing the body to create a false passageway to continue blood flow. They can cause the heart to have to work harder to provide the necessary blood to all regions of the body, thus leading to various heart conditions. It can also cause loss of blood flow to the limbs resulting in pain, infection, swelling, skin changes, or amputation.
If the condition causes heart failure, then it is rated 100%. If the heart has not failed, but is enlarged with a rapid pulse and a wide pulse pressure , then it is rated 60%. If the heart is not affected, but in an arm, there is swelling, stasis dermatitis, and either tears in the skin or a cellulitis infection, then it is rated 40%. If a leg has swelling, stasis dermatitis, and either tears in the skin or a cellulitis infection, it is rated 50%. If there is only swelling or stasis dermatitis in a leg, then it is rated 30%. If the swelling or stasis dermatitis is in an arm, it is rated 20%.
Blood Flow Restrictions and Blocks
Code 7119: Erythromelalgia is a disorder that causes the blood vessels in the legs or hands to be periodically blocked, often on and off daily. This can cause swelling, redness, and pain. A “characteristic attack” consists of burning pain in the hands or feet with redness and heat. The symptoms normally occur equally in both hands or both feet at the same time. Regardless of how many areas are affected, only one rating is given for this condition as a whole.
A 100% rating is given if characteristic attacks occur more than once a day, lasting an average of more than 2 hours each. They respond poorly to treatment and restrict most daily activities. A rating of 60% is given if characteristic attacks occur more than once a day, lasting an average of more than 2 hours each. They respond poorly to treatment, but do not restrict most daily activities. A rating of 30% is given if characteristic attacks occur at least daily, but respond to treatment. A rating of 10% is given if characteristic attacks do not occur daily, but do occur at least 3 times a week and respond to treatment.
Severe Allergic Swelling
Code 7118: Angioneurotic edema (a.k.a. angioedema or anaphylaxis) is a rapid allergic reaction that causes severe swelling just below the skin. The swelling most often occurs in the face and can cause the throat to swell and close up, although it can occur elsewhere. If there are attacks with swelling of the throat occurring 3 or more times a year, or if there are attacks that do not affect the throat lasting 1 or more days and occurring more than 8 times a year, then it is rated 40%. If there are attacks with swelling of the throat occurring 1 or 2 times a year, or if there are attacks that do not affect the throat lasting 1 or more days and occurring 5 to 8 times a year, it is rated 20%. If there are attacks that do not affect the throat lasting 1 or more days and occurring 2 to 4 times a year, it is rated 10%.
Residual Symptoms from Vein and Artery Conditions
Code 7120 and 7121 are rated on the same system.
Code 7120: Varicose veins are veins that swell and have trouble moving blood in the right direction. They occasionally are painful.
Code 7121: Post-phlebitic syndrome can be caused by numerous different vein conditions. Basically, this is the catch-all term to describe any lasting symptoms of vein conditions. These symptoms can include pain, swelling, itching, tingling, skin discoloration, and open skin wounds. Circulatory disturbances are rated under this code.
The ratings:
Note: These ratings are for a single arm or leg at a time. If multiple extremities are involved, each receives its own rating.
A 100% rating is given if there is severe swelling to the extent that the limb is stiff like a board and there is constant pain at rest. A 60% rating is given if there is persistent swelling or a hardened bump under the skin, skin discoloration or itchy rashes, and an open skin wound that won’t heal. A 40% rating is given if there is persistent swelling and skin discoloration or itchy rashes whether or not there is an open wound. A 20% rating is given if there is persistent swelling that cannot be relieved by elevating the affected part whether or not skin discoloration or rashes are present. A 10% rating is given if there is occasional swelling or aching after prolonged use but the symptoms are relieved by rest, elevation or compression. A 0% rating is given if the veins can be felt or seen but are not symptomatic.
Cancer of the Blood Vessels
Sarcoma is a kind of cancer that is made up of diseased cells of the body parts it affects. So soft tissue sarcoma of the blood vessels is made up of diseased blood vessel cells. Any kind of cells in the body (bone, fat, etc) can create sarcoma cells, but sarcoma is very rare.
Code 7123: Sarcoma of the blood vessels is rated 100% while active. This rating will continue for the first 6 months following treatment. After that time, the condition will be reevaluated and rated based on its continuing symptoms.
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