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6845 – Chronic Pleural Effusion or Fibrosis

Description Rating
6845 Chronic pleural effusion or fibrosis.
General Rating Formula for Restrictive Lung Disease (diagnostic codes 6840 through 6845):
FEV-1 less than 40 percent of predicted value, or FEV-1/FVC less than 40 percent, or DLCO (SB) less than 40-percent predicted, or max exercise capacity less than 15 ml/kg/min oxygen consumption (cardiac/respiratory limit), or cor pulmonale, right ventricular hypertrophy, pulmonary hypertension, episode(s) of acute respiratory failure, or requires outpatient oxygen therapy 100
FEV-1 of 40-55% predicted, or FEV-1/FVC of 40-55%, or DLCO (SB) of 40-55% predicted, or max oxygen consumption of 15-20 ml/kg/min (cardiorespiratory limit) 60
FEV-1 of 56-70% predicted, or FEV-1/FVC of 56-70%, or DLCO (SB) of 56-65% predicted 30
FEV-1 of 71-80% predicted, or FEV-1/FVC of 71-80%, or DLCO (SB) of 66-80% predicted 10
Or rate primary disorder

Note (1): A 100-percent rating shall be assigned for pleurisy with empyema, with or without pleurocutaneous fistula, until resolved.

Note (2): Following episodes of total spontaneous pneumothorax, a rating of 100 percent shall be assigned as of the date of hospital admission and shall continue for three months from the first day of the month after hospital discharge.

Note (3): Gunshot wounds of the pleural cavity with bullet or missile retained in lung, pain or discomfort on exertion, or with scattered rales or some limitation of excursion of diaphragm or of lower chest expansion shall be rated at least 20-percent disabling. Disabling injuries of shoulder girdle muscles (Groups I to IV) shall be separately rated and combined with ratings for respiratory involvement. Involvement of Muscle Group XXI (DC 5321), however, will not be separately rated.

1 Review for entitlement to special monthly compensation under § 3.350 of this chapter.