VA Diagnostic Code 7114Peripheral arterial disease

Rated from 20% to 100% under § 4.104. Here is what the VA requires at each level.

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100%Maximum
At least one of the following: Ankle/brachial index less than or equal to 0.39; ankle pressure less than 50 mm Hg; toe pressure less than 30 mm Hg; or transcutaneous oxygen tension less than 30 mm Hg
60%
At least one of the following: Ankle/brachial index of 0.40-0.53; ankle pressure of 50-65 mm Hg; toe pressure of 30-39 mm Hg; or transcutaneous oxygen tension of 30-39 mm Hg
40%
At least one of the following: Ankle/brachial index of 0.54-0.66; ankle pressure of 66-83 mm Hg; toe pressure of 40-49 mm Hg; or transcutaneous oxygen tension of 40-49 mm Hg
20%
At least one of the following: Ankle/brachial index of 0.67-0.79; ankle pressure of 84-99 mm Hg; toe pressure of 50-59 mm Hg; or transcutaneous oxygen tension of 50-59 mm Hg

From the schedule

Notes on this code

These notes are part of the regulation. They change how the levels above are applied.

Note (1): The ankle/brachial index (ABI) is the ratio of the systolic blood pressure at the ankle divided by the simultaneous brachial artery systolic blood pressure. For the purposes of this diagnostic code, normal ABI will be greater than or equal to 0.80. The ankle pressure (AP) is the systolic blood pressure measured at the ankle. Normal AP is greater than or equal to 100 mm Hg. The toe pressure (TP) is the systolic blood pressure measured at the great toe. Normal TP is greater than or equal to 60 mm Hg. Transcutaneous oxygen tension (Tc PO2) is measured at the first intercostal space on the foot. Normal Tc PO2 is greater than or equal to 60 mm Hg. All measurements must be determined by objective testing.
Note (2): If AP, TP, and Tc PO2 testing are not of record, evaluate based on ABI unless the examiner states that an AP, TP, or Tc PO2 test is needed in a particular case because ABI does not sufficiently reflect the severity of the veteran's peripheral arterial disease. In all other cases, evaluate based on the test that provides the highest impairment value
Note (3): Evaluate residuals of aortic and large arterial bypass surgery or arterial graft as peripheral arterial disease.
Note (4): These evaluations involve a single extremity. If more than one extremity is affected, evaluate each extremity separately and combine (under § 4.25), using the bilateral factor (§ 4.26), if applicable.

Peripheral Arterial Disease (VA Diagnostic Code 7114)

Understanding how the VA rates peripheral arterial disease under 38 CFR § 4.104.

What This Condition Is

Peripheral arterial disease is a cardiovascular condition. The VA rates it under Diagnostic Code 7114 within the Cardiovascular System, found in § 4.104.

The VA measures the severity of this condition using objective testing. Four measurements can be used:

Ankle/Brachial Index (ABI): the ratio of the systolic blood pressure at the ankle divided by the simultaneous brachial artery systolic blood pressure. Normal ABI is greater than or equal to 0.80.
Ankle Pressure (AP): the systolic blood pressure measured at the ankle. Normal AP is greater than or equal to 100 mm Hg.
Toe Pressure (TP): the systolic blood pressure measured at the great toe. Normal TP is greater than or equal to 60 mm Hg.
Transcutaneous Oxygen Tension (Tc PO2): measured at the first intercostal space on the foot. Normal Tc PO2 is greater than or equal to 60 mm Hg.

All measurements must be determined by objective testing.

Available Rating Levels

Each rating below applies to a single extremity. Meeting at least one of the listed criteria qualifies for that level.

Rating	What Qualifies (any one of the following)
100%	ABI of 0.39 or less; ankle pressure less than 50 mm Hg; toe pressure less than 30 mm Hg; or transcutaneous oxygen tension less than 30 mm Hg
60%	ABI of 0.40–0.53; ankle pressure of 50–65 mm Hg; toe pressure of 30–39 mm Hg; or transcutaneous oxygen tension of 30–39 mm Hg
40%	ABI of 0.54–0.66; ankle pressure of 66–83 mm Hg; toe pressure of 40–49 mm Hg; or transcutaneous oxygen tension of 40–49 mm Hg
20%	ABI of 0.67–0.79; ankle pressure of 84–99 mm Hg; toe pressure of 50–59 mm Hg; or transcutaneous oxygen tension of 50–59 mm Hg

What the VA Looks For

Objective test results. Ratings are based on the specific measured values from ABI, AP, TP, or Tc PO2 testing.
Which test is used. If AP, TP, and Tc PO2 testing are not of record, the VA evaluates based on ABI — unless the examiner states that an AP, TP, or Tc PO2 test is needed in a particular case because ABI does not sufficiently reflect the severity of the condition. In all other cases, the VA evaluates based on the test that provides the highest impairment value.
Surgical residuals. Residuals of aortic and large arterial bypass surgery or arterial graft are evaluated as peripheral arterial disease.
Multiple extremities. These evaluations involve a single extremity. If more than one extremity is affected, the VA evaluates each extremity separately and combines them under § 4.25, using the bilateral factor (§ 4.26) if applicable.

This information is drawn directly from the VA rating schedule under 38 CFR § 4.104, Diagnostic Code 7114. It is provided for general educational purposes and does not guarantee any particular rating outcome.

These criteria are a rendering of § 4.104, diagnostic code 7114. The official version is the one that governs your rating.

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