Basic (10-23)

DI 33526.070 Impairment Codes for Immune System Disorders

Use the impairment codes in this section to identify disorders in the immune body system.

A. When an immune system disorder meets or equals a Part A listing

Use the appropriate impairment code from the following table if the immune system disorder meets or equals a Part A listing. If a code in the table has an asterisk (*), see the reminders in DI 33526.070E.

Immune Impairment Codes for Part A Listings

Part A Listing

Impairment Code

Impairment Descriptor

14.02

7100

Systemic Lupus Erythematosus

14.03

4460

Systemic Vasculitis (Periarteritis Nodosa and Allied Conditions)

14.04

7100

Systemic Sclerosis (Scleroderma)

14.05

7100

Polymyositis and Dermatomyositis

14.06

7100

Undifferentiated and Mixed Connective Tissue Disease

14.07

2790

Immune Deficiency Disorders, Excluding HIV Infection

14.09

7140

Inflammatory Arthritis

14.09C

7200

Ankylosing Spondylitis or Other Spondyloarthropathies

14.10

7100

Sjogren's Syndrome

14.11

*0430

Symptomatic Human Immunodeficiency Virus (HIV) Infection

B. When an immune system disorder meets or medically equals a Part B listing

Use the appropriate impairment code from the following table if the immune system disorder meets or medically equals a Part B listing:

Immune Impairment Codes for Part B Listings

Part B Listing

Impairment Code

Impairment Descriptor

114.02

7100

Systemic Lupus Erythematosus

114.03

4460

Systemic Vasculitis (Periarteritis Nodosa and Allied Conditions)

114.04

7100

Systemic Sclerosis (Scleroderma)

114.05

7100

Polymyositis and Dermatomyositis

114.06

7100

Undifferentiated and Mixed Connective Tissue Disease

114.07

2790

Immune Deficiency Disorder, Excluding HIV Infection

114.09

7140

Inflammatory Arthritis

114.09C

7200

Ankylosing Spondylitis or Other Spondyloarthropathies

114.10

7100

Sjogren's Syndrome

114.11

*0430

Symptomatic Human Immunodeficiency Virus (HIV) Infection

C. When an immune system disorder does not meet or equal a listing

Use the appropriate impairment code from the following table if the immune system disorder does not meet or equal a listing:

General Impairment Codes for Immune System Disorders

Impairment Descriptor

Impairment Code

Ankylosing Spondylitis or Other Spondyloarthropathies

7200

Asymptomatic Human Immunodeficiency Virus (HIV) Infection

*0440

Diffuse Diseases of Connective Tissue (Inclusing Systemic Lupus Erythematosus, System Sclerosis (Scleroderma), Polymyositis and Dermatomyositis, Undifferentiated and Mixed Connective Tissue Disease, Sjögren’s Syndrome)

7100

Valvular Heart Disease or Other Stenotic Defects or Valvular Regurgitation

4240

Gout

2740

Immune Deficiency Disorders, Excluding HIV Infection

2790

Inflammatory Arthritis

7140

Pneumonia (non-PCP)

4860

Symptomatic Human Immunodeficiency Virus (HIV) Infection

*0430

Systemic Vasculitis (Periarteritis Nodosa and Allied Conditions)

4460

D. Impairment codes for secondary diagnosis associated with symptomatic HIV infection

When the impairment code for symptomatic HIV (0430) is recorded in the Primary Diagnosis block of the SSA-831 (Item 16A), SSA-832 (Item 21), or SSA-833 (Item 21), use the appropriate code from the table below to identify the manifestation of HIV in the Secondary Diagnosis block (Item 16B of the SSA-831, or Item 22 of the SSA-832 or SSA-833). Do not use the codes in this table in the Primary Diagnosis block of the SSA-831, SSA-832, or SSA-833.

Secondary Impairment Codes for Symptomatic HIV Infection

Impairment Descriptor

Impairment Code

Absolute CD4 Count 50 or Less

7950

Cancer of Cervix

1800

Microcephaly

7420

Multicentric Castleman Disease

2380

Opportunistic Infections Associated with HIV Infection

*1390

Primary Effusion Lymphoma

2000

Progressive Multifocal Leukoencephalopathy

0460

Pulmonary Kaposi Sarcoma

1760

Pulmonary Lymphoid Hyperplasia (PLH)

2850

E. Reminders for choosing an impairment code for immune system disorders

  • Use impairment code 0430 as the primary impairment code for a favorable determination based on HIV infection.

  • Do not use 0440 as the primary impairment code for a favorable determination. Because the primary impairment code is the basis for the allowance, this would mean the determination was based on HIV infection which has no symptoms, signs, or manifestations.

  • Use impairment code 1390 for any opportunistic infection that is associated with symptomatic HIV infection. This includes any bacterial, viral, parasitic, or fungal disease. Examples of diseases under this code include: toxoplasmosis, candidiasis, salmonella bacteremia, herpes simplex, cytomegalovirus, and syphilis.

  • If DI 33526.070D does not include an impairment code for the HIV manifestation, and impairment code 1390 would not be appropriate, use a code from the list of impairment codes for the appropriate body system.

 


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0433526070
DI 33526.070 - Impairment Codes for Immune System Disorders - 10/06/2023
Batch run: 10/06/2023
Rev:10/06/2023