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6829 – Drug-Induced Pulmonary Pneumonitis and Fibrosis

Description Rating
6829 Drug-induced pulmonary pneumonitis and fibrosis.
General Rating Formula for Interstitial Lung Disease (diagnostic codes 6825 through 6833):
Forced Vital Capacity (FVC) less than 50-percent predicted, or Diffusion Capacity of the Lung for Carbon Monoxide by the Single Breath Method (DLCO (SB)) less than 40-percent predicted, or max exercise capacity less than 15 ml/kg/min oxygen consumption with cardiorespiratory limitation, or cor pulmonale or pulmonary hypertension, or requires outpatient oxygen therapy 100
FVC of 50-64% predicted, or DLCO (SB) of 40-55% predicted, or max exercise capacity 15-20 ml/kg/min oxygen consumption with cardiorespiratory limitation 60
FVC of 65-74% predicted, or DLCO (SB) of 56-65% predicted 30
FVC of 75-80% predicted, or DLCO (SB) of 66-80% predicted 10