Effective Dates: 10/06/2023 - Present Previous | Next

Basic (10-23)

DI 33526.025 Impairment Codes for Digestive Disorders

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

A. When a digestive disorder meets or equals a Part A Listing

Use the appropriate impairment code from the following table if the digestive disorder meets or equals a Part A listing. If a code in the table has an asterisk (*), see the reminders in DI 33526.025D.

Digestive Impairment Codes for Part A Listings

Part A Listing

Impairment Code

Impairment Descriptor

5.02

5780

Gastrointestinal Hemorrhage

5.05

5710

Chronic Liver Disease

5.06

5550

Inflammatory Bowel Disease (IBD)

5.07

5793

Intestinal Failure

5.08

2630

Weight Loss/Growth Failure Due to Any Digestive Disorder

5.09

*4750

Liver Transplant

5.11

4690

Small Intestine Transplantation

5.12

5280

Pancreas Transplantation

B. When a digestive disorder meets or medically equals a Part B listing

Use the appropriate impairment code from the following table if the digestive disorder does not meet or medically equal a Part B listing:

Digestive Impairment Codes for Part B Listings

Part B Listing

Impairment Code

Impairment Descriptor

105.02

5780

Gastrointestinal Hemorrhage

105.05

5710

Chronic Liver Disease

105.06

5550

Inflammatory Bowel Disease (IBD)

105.07

5793

Intestinal Failure

105.08

2630

Weight Loss/Growth Failure Due to Any Digestive Disorder

105.09

*4750

Liver Transplant

105.10

*5799

Need for Supplemental Daily Enteral Feeding via Gastrostomy, Duodenostomy, or Jejunostomy (Under Age 3)

105.11

4690

Small Intestine Transplantation

105.12

5280

Pancreas Transplantation

C. When a digestive disorder does not meet or equal a listing

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

Digestive Disorders

Impairment Descriptor

Impairment Code

Chronic Liver Disease

5710

Congenital Anomalies of Upper Alimentary Tract

7500

Disease of Esophagus

5300

Gastritis and Duodenitis

5350

Gastrointestinal Hemorrhage

5780

Hernias

5530

Inflammatory Bowel Disease (IBD)

5550

Intestinal Failure

 5793

Liver Transplant

*4750

Need for Supplemental Daily Enteral Feeding via Gastrostomy, Duodenostomy, or Jejunostomy (Under Age 3)

*5799

Other Disorders of Gastrointestinal System

5690

Other Infectious and Parasitic Disorders

1360

Pancreas Transplantation

5280

Peptic Ulcer (Gastric or Duodenal)

5330

Small Intestine Transplantation

4690

Weight Loss or Growth Failure Due to Any Digestive Disorder

2630

D. Reminders for choosing an impairment code for digestive disorders

  • •

    Do not use 5799 if the person is over age three at the time of adjudication.

  • •

    Do not use 4750 for favorable determinations more than one year after the date of the transplant. Use the code for the residual impairment that is the basis for the allowance.

To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0433526025
DI 33526.025 - Impairment Codes for Digestive Disorders - 10/06/2023
Batch run: 10/06/2023
Rev:10/06/2023