38 CFR Part 4 — 38 CFR § 4.117

Pernicious anemia and Vitamin B12 deficiency anemia — VA Diagnostic Code 7722

Hematologic / lymphatic

Diagnostic code

7722

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38 CFR § 4.117 lists Diagnostic Code 7722 as “Pernicious anemia and Vitamin B12 deficiency anemia:”. The 12 in B12 is a subscript in the title, in the 10 percent line, and in the note. The lines are 100 and 10. Appendix B to Part 4 uses the same words, with the same subscript and a period instead of 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 § 4.117 source note prints 60 FR 49227, Sept. 22, 1995, as amended at 77 FR 6467, Feb. 8, 2012; 79 FR 2100, Jan. 13, 2014; 83 FR 54254, Oct. 29, 2018; 83 FR 54881, Nov. 1, 2018; 87 FR 61248, Oct. 11, 2022.

The rating criteria at each level

7722 Pernicious anemia and Vitamin B12 deficiency anemia

Rating %: 100

Criteria (verbatim). For initial diagnosis requiring transfusion due to severe anemia, or if there are signs or symptoms related to central nervous system impairment, such as encephalopathy, myelopathy, or severe peripheral neuropathy, requiring parenteral B12 therapy

Rating %: 10

Criteria (verbatim). Requiring continuous treatment with Vitamin B12 injections, Vitamin B12 sublingual or high-dose oral tablets, or Vitamin B12 nasal spray or gel

Rating %	Criteria (verbatim)
100	For initial diagnosis requiring transfusion due to severe anemia, or if there are signs or symptoms related to central nervous system impairment, such as encephalopathy, myelopathy, or severe peripheral neuropathy, requiring parenteral B12 therapy
10	Requiring continuous treatment with Vitamin B12 injections, Vitamin B12 sublingual or high-dose oral tablets, or Vitamin B12 nasal spray or gel

Note: A 100 percent evaluation for pernicious anemia and Vitamin B12 deficiency shall be assigned as of the date of the initial diagnosis requiring transfusion due to severe anemia or parenteral B12 therapy and shall continue with a mandatory VA examination six months following hospital discharge or cessation of parenteral B12 therapy. Any reduction in evaluation based upon that or any subsequent examination shall be subject to the provisions of § 3.105(e) of this chapter. Thereafter, evaluate at 10 percent and separately evaluate any residual effects of pernicious anemia, such as neurologic involvement causing peripheral neuropathy, myelopathy, dementia, or related gastrointestinal residuals, under the most appropriate diagnostic code

The note does not end with a period. It assigns the 100 percent evaluation as of the date of the initial diagnosis requiring transfusion due to severe anemia or parenteral B12 therapy, continues it with a mandatory VA examination six months following hospital discharge or cessation of parenteral B12 therapy, and then says to evaluate at 10 percent and separately evaluate named residual effects under the most appropriate diagnostic code. A reduction follows 38 CFR § 3.105(e). 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.

38 CFR § 4.31 says that in every instance where the schedule does not provide a zero percent evaluation for a diagnostic code, a zero percent evaluation shall be assigned when the requirements for a compensable evaluation are not met. DC 7722 does not print a 0 percent line.

The 12 is a subscript wherever B12 appears in this block, including “parenteral B12 therapy.” This page writes B12 on one line so the sentence can be read. It is still the subscript in the regulation.

Source: 38 CFR § 4.117, Diagnostic Code 7722, eCFR full-text XML for 2026-10-01.

What the words mean in your records

Two different 100 percent triggers

The 100 percent cell joins them with “or”: initial diagnosis requiring transfusion due to severe anemia, or signs or symptoms related to central nervous system impairment, such as encephalopathy, myelopathy, or severe peripheral neuropathy, requiring parenteral B12 therapy.

The 10 percent forms of B12

The 10 percent line names Vitamin B12 injections, Vitamin B12 sublingual or high-dose oral tablets, or Vitamin B12 nasal spray or gel. It says “continuous treatment.” The word “Vitamin” is capitalized on that line.

Residuals named in the note

The note’s “such as” list is neurologic involvement causing peripheral neuropathy, myelopathy, dementia, or related gastrointestinal residuals. It says to evaluate those under the most appropriate diagnostic code. It does not name that code.

Evidence that speaks to each level

100

What the rater needs to see. Initial diagnosis requiring transfusion due to severe anemia, or central-nervous-system signs or symptoms such as encephalopathy, myelopathy, or severe peripheral neuropathy, requiring parenteral B12 therapy.

Where that usually lives. The diagnosis date, the transfusion record, or the record of parenteral B12 therapy.

10, and separate residuals

What the rater needs to see. Continuous treatment with one of the Vitamin B12 forms the line names, and any residual the note says to evaluate separately.

Where that usually lives. The treatment record and the neurologic or gastrointestinal findings, if the note’s separate evaluation is used.

Level	What the rater needs to see	Where that usually lives
100	Initial diagnosis requiring transfusion due to severe anemia, or central-nervous-system signs or symptoms such as encephalopathy, myelopathy, or severe peripheral neuropathy, requiring parenteral B12 therapy.	The diagnosis date, the transfusion record, or the record of parenteral B12 therapy.
10, and separate residuals	Continuous treatment with one of the Vitamin B12 forms the line names, and any residual the note says to evaluate separately.	The treatment record and the neurologic or gastrointestinal findings, if the note’s separate evaluation is used.

VA’s public DBQ list, checked October 5, 2026, names “Hematologic and Lymphatic Conditions, Including Leukemia” under Hematologic & Lymphatic. The file is Hematologic and Lymphatic Conditions, Including Leukemia.

The exam form

DC 7722 prints the 100 and 10 percent lines and the note. This page does not say the form replaces those lines.

Related codes and how they interact

Other anemia codes are not this title.

DC 7720 is iron deficiency anemia. DC 7721 is folic acid deficiency. Neither title is printed on DC 7722.

Secondary conditions and presumptions

38 CFR § 3.309(a) says “Anemia, primary.” It does not say “Pernicious anemia” or “Vitamin B12 deficiency anemia.” That chronic-disease row has no diagnostic code. This page does not assign it to DC 7722. The 2026-10-01 text of § 3.309 does not contain “pernicious” or “B12.”

Short answers

What is the VA rating for pernicious anemia?

Under 38 CFR § 4.117, Diagnostic Code 7722 is 100 or 10 percent, as the lines print, with the six-month note. Education only. VA decides on the evidence.

How is B12 printed?

The 12 is a subscript in the title, on the 10 percent line, and in the note, including “parenteral B12 therapy.” Appendix B uses the same subscript.

FAQ

How does VA rate pernicious anemia and Vitamin B12 deficiency anemia under DC 7722?

The 100 percent line is an initial diagnosis requiring transfusion due to severe anemia, or central-nervous-system impairment such as encephalopathy, myelopathy, or severe peripheral neuropathy, requiring parenteral B12 therapy. The 10 percent line is continuous treatment with Vitamin B12 injections, sublingual or high-dose oral tablets, or nasal spray or gel. The note sets the 100 percent evaluation from the qualifying diagnosis date, requires an examination six months after hospital discharge or cessation of parenteral B12 therapy, and then says to evaluate at 10 percent and separately evaluate named residuals. Education only.

Is this the “Anemia, primary” presumption?

Section 3.309(a) says “Anemia, primary.” It does not say pernicious anemia or Vitamin B12 deficiency anemia, and that row does not assign DC 7722.

Does the note name a code for the residuals?

No. It says to evaluate neurologic involvement causing peripheral neuropathy, myelopathy, dementia, or related gastrointestinal residuals under the most appropriate diagnostic code.

Next steps

Read the decision for DC 7722, the transfusion or parenteral B12 dates, and any separate residual code.
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 hemic and lymphatic codes are on the hematologic and lymphatic diagnostic-code index.

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 Hematologic / lymphatic, ordered by diagnostic code number. All Hematologic / lymphatic codes

Also: DC code lookup (tools) lists the same index in a compact layout.

Source: 38 CFR Part 4, Diagnostic Code 7722 • 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.