Note (1): When an evaluation is assigned for joint resurfacing or the prosthetic replacement of a joint under diagnostic codes 5051-5056, an additional rating under § 4.71a may not also be assigned for that joint, unless otherwise directed.
Note (2): Only evaluate a revision procedure in the same manner as the original procedure under diagnostic codes 5051-5056 if all the original components are replaced.
Note (3): The term “prosthetic replacement” in diagnostic codes 5051-5053 and 5055-5056 means a total replacement of the named joint. However, in DC 5054, “prosthetic replacement” means a total replacement of the head of the femur or of the acetabulum.
Note (4): The 100 percent rating for 1 year following implantation of prosthesis will commence after initial grant of the 1-month total rating assigned under § 4.30 following hospital discharge.
Note (5): The 100 percent rating for 4 months following implantation of prosthesis or resurfacing under DCs 5054 and 5055 will commence after initial grant of the 1-month total rating assigned under § 4.30 following hospital discharge.
Note (6): Special monthly compensation is assignable during the 100 percent rating period the earliest date permanent use of crutches is established.
| Rating Criteria | Rating Percentage (Major / Minor) |
|---|---|
| 5051 shoulder replacement: | |
| Prostethic replacement of shouder joint | |
| For 1 year following implantation of prosthesis | 100 |
| With chronic residuals consisting of severe, painful motion or weakness in the affected extremity | 60 / 50 |
| With intermediate degrees of residual weakness, pain or limitation of motion, rate by analogy to diagnostic codes 5200 and 5203. | |
| Minimum rating | 30 / 20 |
With intermediate degrees of residual weakness, pain or limitation of motion, rate by analogy to diagnostic codes 5200 and 5203. See the rating schedules for 5200 and 5203 below.
5200
| Rating Criteria | Major | Minor |
|---|---|---|
| 5200 Scapulohumeral articulation, ankylosis of: | ||
| Note: The scapula and humerus move as one piece. | ||
| Unfavorable, abduction limited to 25° from side | 50 | 40 |
| Intermediate between favorable and unfavorable | 40 | 30 |
| Favorable, abduction to 60°, can reach mouth and head | 30 | 20 |
5203
| Rating Criteria | Major | Minor |
|---|---|---|
| 5203 Clavicle or scapula, impairment of: | ||
| Dislocation of | 20 | 20 |
| Nonunion of: | ||
| With loose movement | 20 | 20 |
| Without loose movement | 10 | 10 |
| Malunion of | 10 | 10 |
Or rate on impairment of function of contiguous joint.