EDPNA Digestive for: Fiscal Year 2024
Summary
This training presents the revised listings for evaluating digestive disorders.
Objectives
Discuss the updated introductory text and changes in timeframes and affected listings.
Key Points
This video presents and overview of the updates to the listing for evaluating digestive disorders with adults and children. The presentation places emphasis on how the updates affects how to evaluate claims for both adults and children.
References:
Revised Medical Criteria for Evaluating Digestive Disorders and Skin Disorders Final Rule 88 FR 37704
Title 20 of the Code of Federal Regulations, or CFR, at 404.1535 and 416.935
https://www.ssa.gov/disability/professionals/bluebook/
SSR 13-2p: Titles II and XVI: Evaluating Cases Involving Drug Addiction and Alcoholism (DAA)
SSR 18-3 Failure to Follow Prescribed Treatment
SSR 17-2p Titles II and XVI: Evidence Needed by Adjudicators at the Hearings and Appeals Council Levels of the Administrative Review Process to Make Findings about Medical Equivalence
Impairment Codes found in DI 33526.025 Impairment Codes for Digestive Disorders
- 5.02 Gastrointestinal hemorrhaging from any cause, requiring three blood transfusions;
- 5.05 Chronic liver disease (CLD);
- 5.06 Inflammatory bowel disease (IBD);
- 5.07 Intestinal failure;
- 5.08 Weight loss due to any digestive disorder;
- 5.09 Liver transplantation;
- 5.11 Small intestine transplantation; and
- 5.12 Pancreas transplantation.
- 105.02 Gastrointestinal hemorrhaging from any cause, requiring three blood transfusions;
- 105.05 Chronic liver disease (CLD);
- 105.06 Inflammatory bowel disease (IBD);
- 105.07 Intestinal failure;
- 105.08 Growth failure due to any digestive disorder;
- 105.09 Liver transplantation;
- 105.10 Need for supplemental daily enteral feeding via a gastrostomy, duodenostomy, or jejunostomy;
- 105.11 Small intestine transplantation; and
- 105.12 Pancreas transplantation
DI 24508.010 Impairment or Combination of Impairments Equaling a Listing – Medical Equivalence
DI 33526.025 Impairment Codes for Digestive Disorders
DI 34001.018 Digestive Disorders
DI 34005.105 Digestive Disorders
Please take a few minutes to complete the optional end of course survey.