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7121 – Post-Phlebitic Syndrome of Any Etiology

Description Rating
7121 Post-phlebitic syndrome of any etiology:
With the following findings attributed to venous disease:
Massive board-like edema with constant pain at rest 100
Persistent edema or subcutaneous induration, stasis pigmentation or eczema, and persistent ulceration 60
Persistent edema and stasis pigmentation or eczema, with or without intermittent ulceration 40
Persistent edema, incompletely relieved by elevation of extremity, with or without beginning stasis pigmentation or eczema 20
Intermittent edema of extremity or aching and fatigue in leg after prolonged standing or walking, with symptoms relieved by elevation of extremity or compression hosiery 10
Asymptomatic palpable or visible varicose veins 0
GENERAL RATING FORMULA FOR DISEASES OF THE HEART:
During and for three months following myocardial infarction, confirmed by laboratory tests 100
Thereafter, use the General Rating Formula
Workload of 3.0 METs or less results in heart failure symptoms 100
Workload of 3.1-5.0 METs results in heart failure symptoms 60
Workload of 5.1-7.0 METs results in heart failure symptoms; or evidence of cardiac hypertrophy or dilatation confirmed by echocardiogram or equivalent (e.g., multigated acquisition scan or MRI) 30
Workload of 7.1-10.0 METs results in heart failure symptoms; or continuous medication required for control 10

Note: These evaluations are for involvement of a single extremity. If more than one extremity is involved, evaluate each extremity separately and combine (under § 4.25), using the bilateral factor (§ 4.26), if applicable.