Hypothyroidism — VA Diagnostic Code 7903

Myxedema

The 100 percent line is “Hypothyroidism manifesting as myxedema,” followed by the features in parentheses: cold intolerance, muscular weakness, cardiovascular involvement (including, but not limited to hypotension, bradycardia, and pericardial effusion), and mental disturbance (including, but not limited to dementia, slowing of thought and depression). That sentence in § 4.119 is the rating text. The public Thyroid and Parathyroid form adds its own note: “For VA purposes, myxedema, often referred to as myxedema coma or myxedema crisis, is defined as a rare, life-threatening condition from severe hypothyroidism which requires hospitalization for stabilization and may affect several body systems.” That definition is on the form. It is not the sentence in § 4.119.

Crisis stabilization

Note (1) runs the 100 percent evaluation for six months beyond “the date that an examining physician has determined crisis stabilization.” The schedule does not add a further definition of that date. The public form asks, when myxedema has stabilized, for “the date of stabilization as determined by the examining physician.”

Initial diagnosis

Note (2) runs the 30 percent evaluation for six months after “initial diagnosis.” The schedule does not define that date. 38 CFR § 4.6 requires each element affecting the evidence to be studied so that decisions will be equitable and just. 38 CFR § 4.7 assigns the higher evaluation when the disability picture more nearly approximates the criteria required for that rating. Otherwise, the lower rating will be assigned. Our reading: the date is the first documented diagnosis. That date is our reading, not a definition printed in § 4.119.

Residuals

Note (1) says that after its six months, “the residual effects of hypothyroidism shall be rated under the appropriate diagnostic code(s) within the appropriate body system(s) (e.g., eye, digestive, and mental disorders).” Note (2) says to “rate residuals of disease or medical treatment under the most appropriate diagnostic code(s) under the appropriate body system (e.g., eye, digestive, mental disorders).” The examples printed in the Notes are eye, digestive, and mental disorders. This page does not add residual conditions the Notes do not name.

Medication

DC 7903 prints no medication criterion on the 100 or 30 line. Note (2) does say that, after the six months, the residuals rated are “residuals of disease or medical treatment.” This page does not add a rule about how treatment changes the 100 or 30 line.

Other thyroid codes in § 4.119

Residual systems

Combining

What is the VA rating for hypothyroidism under DC 7903?

Under 38 CFR § 4.119, DC 7903 prints two levels: 100 for hypothyroidism manifesting as myxedema, and 30 for hypothyroidism without myxedema. Note (2) says the 30 continues for six months after initial diagnosis. Note (1) says the 100 continues for six months beyond the date an examining physician determined crisis stabilization. Afterward, the Notes say to rate the residuals under the codes for the body systems affected. Education only. VA decides on the evidence.

What does “rate residuals” mean for hypothyroidism?

The Notes under DC 7903 say that after the six-month period, the residual effects of hypothyroidism, or residuals of disease or medical treatment, are rated under the appropriate diagnostic code or codes in the body system affected. They give eye, digestive, and mental disorders as examples. Eye involvement due to thyroid disease is separately evaluated under § 4.79, Note (3).

How does VA rate hypothyroidism under DC 7903?

Under 38 CFR § 4.119, DC 7903 prints two levels. Hypothyroidism manifesting as myxedema, with the features listed in that line, is 100. Hypothyroidism without myxedema is 30. Note (1) continues the 100 for six months beyond the date an examining physician determined crisis stabilization. Note (2) continues the 30 for six months after initial diagnosis. Afterward, the Notes say to rate the residuals under the body system affected. Education only.

How long does the 30 percent evaluation last?

Note (2) says the 30 percent evaluation shall continue for six months after initial diagnosis. Thereafter, rate residuals of disease or medical treatment under the most appropriate diagnostic code or codes under the appropriate body system. The schedule’s examples are eye, digestive, and mental disorders. The schedule does not define the words “initial diagnosis.”

What is myxedema for this code?

The 100 percent line says “Hypothyroidism manifesting as myxedema” and then lists cold intolerance, muscular weakness, cardiovascular involvement, and mental disturbance, with the examples printed in that line. The public Thyroid and Parathyroid form defines myxedema, for VA purposes, as a rare, life-threatening condition from severe hypothyroidism which requires hospitalization for stabilization and may affect several body systems. The controlling rating text is the line in § 4.119.

What does it mean to rate residuals?

Notes (1) and (2) say that after the six-month period, residual effects of hypothyroidism, or residuals of disease or medical treatment, are rated under the appropriate diagnostic code or codes in the body system affected. The Notes give eye, digestive, and mental disorders as examples. Note (3) says eye involvement due to thyroid disease is also separately evaluated under § 4.79.

What is the maximum under DC 7903?

The highest line printed under DC 7903 is 100, for hypothyroidism manifesting as myxedema. Note (1) continues that evaluation for six months beyond the date an examining physician determined crisis stabilization. The code does not print a percentage above 100, and it does not print a percentage of its own for the time after that period.