38 CFR Part 4 — 38 CFR § 4.114
Esophageal motility disorder — VA Diagnostic Code 7204
Digestive
Diagnostic code
7204
38 CFR § 4.114 lists Diagnostic Code 7204 as “Esophageal motility disorder:”. The title ends with a colon. The rating cell is empty. The next cell is “Rate as esophagus, stricture of (DC 7203).” That cell ends with a period. A note says the code applies, but is not limited to, achalasia (cardiospasm), diffuse esophageal spasm (DES), corkscrew esophagus, nutcracker esophagus, and other motor disorders of the esophagus; esophageal rings (including Schatzki rings), mucosal webs or folds, and impairment of the esophagus caused by systemic conditions such as myasthenia gravis, scleroderma, and other neurologic conditions. Appendix B to Part 4 indexes “Esophageal motility disorder.” with a period and without the colon.
Reviewed 2026-10-05. Text checked against the eCFR versioner full-text XML for 2026-10-01 on 2026-10-05. Title 38 was up to date as of 2026-10-01 and last amended on 2026-08-27. The § 4.114 source note prints 29 FR 6718, May 22, 1964, as amended at 34 FR 5063, Mar. 11, 1969; 40 FR 42540, Sept. 15, 1975; 41 FR 11301, Mar. 18, 1976; 66 FR 29488, May 31, 2001; 89 FR 19743, Mar. 20, 2024. The § 4.112 source note prints 89 FR 19743, Mar. 20, 2024. The § 4.113 XML for this date does not print a Federal Register source note.
The rating criteria at each level
7204 Esophageal motility disorder
Rating %: —
Criteria (verbatim). Rate as esophagus, stricture of (DC 7203).
| Rating % | Criteria (verbatim) |
|---|---|
| — | Rate as esophagus, stricture of (DC 7203). |
7203 Esophagus, stricture of — the code DC 7204 names
Rating %: 80
Criteria (verbatim). Documented history of recurrent or refractory esophageal stricture(s) causing dysphagia with at least one of the symptoms present: (1) aspiration, (2) undernutrition, and/or (3) substantial weight loss as defined by § 4.112(a) and treatment with either surgical correction or percutaneous esophago-gastrointestinal tube (PEG tube)
Rating %: 50
Criteria (verbatim). Documented history of recurrent or refractory esophageal stricture(s) causing dysphagia which requires at least one of the following (1) dilatation 3 or more times per year, (2) dilatation using steroids at least one time per year, or (3) esophageal stent placement
Rating %: 30
Criteria (verbatim). Documented history of recurrent esophageal stricture(s) causing dysphagia which requires dilatation no more than 2 times per year
Rating %: 10
Criteria (verbatim). Documented history of esophageal stricture(s) that requires daily medications to control dysphagia otherwise asymptomatic
Rating %: 0
Criteria (verbatim). Documented history without daily symptoms or requirement for daily medications
| Rating % | Criteria (verbatim) |
|---|---|
| 80 | Documented history of recurrent or refractory esophageal stricture(s) causing dysphagia with at least one of the symptoms present: (1) aspiration, (2) undernutrition, and/or (3) substantial weight loss as defined by § 4.112(a) and treatment with either surgical correction or percutaneous esophago-gastrointestinal tube (PEG tube) |
| 50 | Documented history of recurrent or refractory esophageal stricture(s) causing dysphagia which requires at least one of the following (1) dilatation 3 or more times per year, (2) dilatation using steroids at least one time per year, or (3) esophageal stent placement |
| 30 | Documented history of recurrent esophageal stricture(s) causing dysphagia which requires dilatation no more than 2 times per year |
| 10 | Documented history of esophageal stricture(s) that requires daily medications to control dysphagia otherwise asymptomatic |
| 0 | Documented history without daily symptoms or requirement for daily medications |
Note (1) under DC 7203: Findings must be documented by barium swallow, computerized tomography, or esophagogastroduodenoscopy.
Note (2) under DC 7203: Non-gastrointestinal complications of procedures should be rated under the appropriate system.
Note (3) under DC 7203: This diagnostic code applies, but is not limited to, esophagitis, mechanical or chemical; Mallory Weiss syndrome (bleeding at junction of esophagus and stomach due to tears) due to caustic ingestion of alkali or acid; drug-induced or infectious esophagitis due to Candida, virus, or other organism; idiopathic eosinophilic, or lymphocytic esophagitis; esophagitis due to radiation therapy; esophagitis due to peptic stricture; and any esophageal condition that requires treatment with sclerotherapy.
Note (4) under DC 7203: Recurrent esophageal stricture is defined as the inability to maintain target esophageal diameter beyond 4 weeks after the target diameter has been achieved.
Note (5) under DC 7203: Refractory esophageal stricture is defined as the inability to achieve target esophageal diameter despite receiving no fewer than 5 dilatation sessions performed at 2-week intervals.
The DC 7204 note is a different sentence from DC 7203 Note (3). The DC 7204 note names achalasia, diffuse esophageal spasm, corkscrew esophagus, nutcracker esophagus, esophageal rings, and the systemic conditions it lists.
[38 CFR § 4.112(a)](https://www.ecfr.gov/current/title-38/chapter-I/part-4/subpart-B/section-4.112) says substantial weight loss means involuntary loss greater than 20% of an individual's baseline weight sustained for three months with diminished quality of self-care or work tasks. The DC 7203 80 percent line cites that paragraph.
38 CFR § 4.7 assigns the higher rating when the disability picture more nearly approximates the criteria required for that rating. Otherwise, the lower rating will be assigned. 38 CFR § 4.6 requires each element affecting the evidence to be studied so that decisions will be equitable and just. DC 7203 prints a 0 percent line: “Documented history without daily symptoms or requirement for daily medications.” The 10 percent line says “otherwise asymptomatic” without a comma before “otherwise.”
DC 7203 is the code the instruction names. DC 7205 is esophagus, diverticulum of, acquired, and it also says to rate as DC 7203. DC 7346 is hiatal hernia and paraesophageal hernia, and it says to rate as DC 7203. DC 7206 is gastroesophageal reflux disease. It prints its own percentage lines. The public page is the GERD guide. DC 7204 is not that code.
The opening of § 4.114 says not to combine ratings under diagnostic codes 7301 through 7329 inclusive, 7331, 7342, 7345 through 7350 inclusive, 7352, and 7355 through 7357 inclusive, with each other. DC 7203 and DC 7204 are not in that list. This page does not turn that absence into a combining rule.
Source: 38 CFR § 4.114, Diagnostic Codes 7204 and 7203, eCFR full-text XML for 2026-10-01.
What the words mean in your records
The percentage table is on 7203
DC 7204 prints the instruction and a note. DC 7203 prints 80, 50, 30, 10, and 0. The 50 percent line has no colon after “following.”
The note names motor disorders and rings
Achalasia is in parentheses as cardiospasm. Diffuse esophageal spasm is in parentheses as DES. Schatzki rings are an example of esophageal rings. Myasthenia gravis and scleroderma are examples of systemic conditions.
Recurrent and refractory are defined on 7203
Note (4) is the 4-week definition of recurrent. Note (5) is the five-session, 2-week-interval definition of refractory. Those notes are printed under DC 7203.
Evidence that speaks to each level
The DC 7204 instruction
What the rater needs to see. A motility disorder the note describes, or another disorder the “not limited to” sentence covers, rated as esophageal stricture under DC 7203.
Where that usually lives. The esophageal examination. DC 7203 Note (1) says findings must be documented by barium swallow, computerized tomography, or esophagogastroduodenoscopy.
The DC 7203 line
What the rater needs to see. The documented stricture history, dysphagia, and the treatment or symptom the line names, including the § 4.112(a) substantial-weight-loss definition on the 80 percent line.
Where that usually lives. Those studies and the treatment record.
VA’s public DBQ list, checked October 5, 2026, names “Esophageal Disorders” under Gastrointestinal. The file linked from that list is Esophageal Disorders.
The exam form
DC 7204 says to rate as DC 7203. This page does not say the form replaces that instruction.
Related codes and how they interact
Three codes point at stricture. GERD prints its own lines.
DC 7204, DC 7205, and DC 7346 each say to rate as DC 7203. DC 7206 is gastroesophageal reflux disease, with its own percentages. The DC 7204 note does not say GERD.
Secondary conditions and presumptions
The 2026-10-01 text of 38 CFR § 3.309(d) lists “Cancer of the esophagus.” That row does not say esophageal motility disorder, and it does not print DC 7204. The text does not contain “achalasia” or “motility.”
A separate question, when a presumption does not decide it, is a medical question on the facts under 38 CFR § 3.310. Paragraph (a) covers disability proximately due to or the result of a service-connected disease or injury. Paragraph (b) covers increase in severity and requires a medical baseline.
Short answers
How does VA rate esophageal motility disorder under DC 7204?
Under 38 CFR § 4.114, Diagnostic Code 7204 says to rate it as esophageal stricture under DC 7203. That code prints 80, 50, 30, 10, and 0. Findings must be documented by barium swallow, computerized tomography, or esophagogastroduodenoscopy. Education only. VA decides on the evidence.
Where is substantial weight loss defined?
Section 4.112(a) says substantial weight loss means involuntary loss greater than 20% of an individual's baseline weight sustained for three months with diminished quality of self-care or work tasks. The DC 7203 80 percent line cites that paragraph.
FAQ
What percentages apply to DC 7204?
DC 7204 says to rate as esophagus, stricture of, DC 7203. Those lines are 80, 50, 30, 10, and 0. Education only.
Which disorders does the DC 7204 note name?
Achalasia (cardiospasm), diffuse esophageal spasm (DES), corkscrew esophagus, nutcracker esophagus, and other motor disorders; esophageal rings (including Schatzki rings), mucosal webs or folds, and impairment caused by systemic conditions such as myasthenia gravis, scleroderma, and other neurologic conditions. The note says the code is not limited to that list.
Is GERD this code?
No. Gastroesophageal reflux disease is DC 7206. It prints its own percentage lines. DC 7204 is esophageal motility disorder, rated as DC 7203.
Next steps
- Read the decision for DC 7204 or DC 7203, the study that documented the findings, and which stricture line was used.
- The free worksheet is a place to write the code, the findings, and the records you already have. It does not file a claim or protect a filing date. An accredited representative is at find a VSO.
- Other digestive codes are on the digestive diagnostic-code index. The category page is digestive conditions.
Education only. Not legal or medical advice. My Claim Packet is not a VA-accredited representative and does not file claims. VA decides every claim on its own evidence.
Other codes in this body system
Nearby catalog entries in Digestive, ordered by diagnostic code number. All Digestive codes
- DC 7200Soft tissue injury of the mouth, other than tongue or lips
- DC 7201Lips, injuries
- DC 7202Tongue, loss of whole or part
- DC 7203Esophagus, stricture
- DC 7205Esophagus, diverticulum
- DC 7206Gastroesophageal reflux disease
- DC 7207Barrett's esophagus
- DC 7301Peritoneum, adhesions of, due to surgery, trauma, or infection
- DC 7303Chronic complications of upper gastrointestinal surgery
- DC 7304Peptic ulcer disease
- DC 7307Gastritis, chronic
- DC 7308Postgastrectomy syndromes
- DC 7309Stomach, stenosis
- DC 7310Stomach, injury of, residuals
- DC 7311Liver, injury of, residuals
- DC 7312Cirrhosis of the liver
Also: DC code lookup (tools) lists the same index in a compact layout.
Source: 38 CFR Part 4, Diagnostic Code 7204 • va.gov
⚠️ Important Disclaimer
This page provides general educational information based on public VA regulations and VA.gov resources. It is not legal or medical advice, and My Claim Packet is not a VA-accredited representative. Any worksheets or draft documents produced by the tools must be reviewed for accuracy and are not filed with VA for you. Ratings and service connection are decided case-by-case from the individual record. Consult a VA-accredited VSO, claims agent, attorney, or qualified clinician for help with your situation, and verify current rules using the linked official source.