Digestive System§ 4.114Updated
Rating criteria

VA Diagnostic Code 7330Intestinal fistulous disease, external

Rated from 30% to 100% under § 4.114. Here is what the VA requires at each level.

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What each rating requires

The VA assigns the highest level your evidence actually supports. Read up the stack until your records stop matching.

  1. 100%

    Requiring total parenteral nutrition (TPN); or enteral nutritional support along with at least one of the following: (1) daily discharge equivalent to four or more ostomy bags (sized 130 cc), (2) requiring ten or more pad changes per day, or (3) a Body Mass Index (BMI) less than 16 and persistent drainage (any amount) for more than 1 month during the past 12 months

  2. 60%

    Requiring enteral nutritional support along with at least one of the following: (1) daily discharge equivalent to three or less ostomy bags (sized 130 cc), (2) requiring fewer than ten pad changes per day, or (3) a Body Mass Index (BMI) of 16 to 18 inclusive and persistent drainage (any amount) for more than 2 months in the past 12 months

  3. 30%

    Intermittent fecal discharge with persistent drainage for more than 3 months in the past 12 months

From the schedule

Notes on this code

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

  • Note: This code applies to external fistulas that have developed as a consequence of abdominal trauma, surgery, radiation, malignancy, infection, or ischemia.

Intestinal Fistulous Disease, External (Diagnostic Code 7330)

Understanding This Condition

An external intestinal fistula is an abnormal opening that connects the intestine to the outside of the body, allowing intestinal contents to drain through the skin. Under the VA's rating schedule, this condition falls within the Digestive System and is evaluated under Diagnostic Code 7330 in § 4.114.

According to VA guidance, this code applies to external fistulas that have developed as a consequence of abdominal trauma, surgery, radiation, malignancy, infection, or ischemia.

Available Rating Levels

The VA assigns one of the following disability ratings based on the severity of the condition and the level of nutritional and drainage-related impact.

100%

Requiring total parenteral nutrition (TPN); or enteral nutritional support along with at least one of the following:

  1. Daily discharge equivalent to four or more ostomy bags (sized 130 cc)
  2. Requiring ten or more pad changes per day
  3. A Body Mass Index (BMI) less than 16 and persistent drainage (any amount) for more than 1 month during the past 12 months

60%

Requiring enteral nutritional support along with at least one of the following:

  1. Daily discharge equivalent to three or less ostomy bags (sized 130 cc)
  2. Requiring fewer than ten pad changes per day
  3. A Body Mass Index (BMI) of 16 to 18 inclusive and persistent drainage (any amount) for more than 2 months in the past 12 months

30%

Intermittent fecal discharge with persistent drainage for more than 3 months in the past 12 months

What the VA Looks For

When rating external intestinal fistulous disease, the VA focuses on measurable indicators of severity, including:

  • Nutritional support requirements — whether total parenteral nutrition (TPN) or enteral nutritional support is needed
  • Volume of discharge — measured in terms of ostomy bag equivalents (sized 130 cc)
  • Pad changes per day — the number required to manage drainage
  • Body Mass Index (BMI) — used at the 100% and 60% levels
  • Persistence and duration of drainage — how many months during the past 12 months drainage or fecal discharge has been present

Documentation reflecting these specific measures helps the VA evaluate which rating level corresponds to the condition.

These criteria are a rendering of § 4.114, diagnostic code 7330. The official version is the one that governs your rating.

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What next

How to claim this

Knowing the criteria is the first half. Getting your file to show them is the second.

  1. Find your level in the stack

    Read each rung against what your medical records already say. The level your records document today is the one the VA can support today.

  2. Name the gap

    Look at the rung above yours and write down exactly what it asks for that your file does not show yet — a diagnosis, a measurement, a prescribed brace, a doctor’s opinion linking it to service.

  3. Claim it by code

    File under diagnostic code 7330 and attach the evidence for the level you are asking for. Other Digestive System codes may cover your secondary conditions.

Find out which rating your evidence supports.

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