38 CFR Part 4 — 38 CFR § 4.114
Peritoneum Adhesions Of Due To Surgery Trauma Or Infection
dc-7301-peritoneum-adhesions-of-due-to-surgery-trauma-or-infection
Digestive
Diagnostic code
7301
Why your DC matters: DC 7301 is the exact code the VA uses to rate this condition. It determines which symptoms unlock which percentage, what evidence the rater looks for, and which secondaries are most likely to be approved.
Last verified against 38 CFR (eCFR Part 4):
Rating criteria (38 CFR Part 4)
Diagnostic code 7301 — Peritoneum Adhesions Of Due To Surgery Trauma Or Infection — is listed under 38 CFR § 4.114 in 38 CFR Part 4. The paragraphs below summarize how this code is used; the official schedule text controls exact percentages, formulas, and notes.
Schedule summary (educational, not a substitute for the regulation): Educational index row from the rating schedule naming convention; confirm exact diagnostic code, effective date, and criteria in the current eCFR Part 4.
Exact rating criteria: Open Part 4 in the eCFR (link under “Official source” below). Locate your diagnostic code number (7301) in the correct body-system subpart, or use Find in Page (Ctrl+F / ⌘F) for “7301”. Copy the verbatim rating table, including any parenthetical notes, exceptions, and cross-references, for the version of Part 4 that applies to your effective date.
Effective dates & which schedule version applies
Which diagnostic code, percentage, and effective date apply depends on the facts of your claim and the version of the rating schedule in force for the period being decided. Generally, VA applies the schedule in effect at the specified time under 38 U.S.C. § 5110 and implementing rules, subject to exceptions (e.g., protected ratings, liberalizing law changes—see regulation and VA manual policy as applicable).
For older claims, the **current** eCFR may not match the text that applied years ago. If your decision references a prior percentage or code, compare against the Part 4 text **as of** your claim’s relevant dates; historical Federal Register / CFR snapshots may be needed for precise comparison.
The “Last verified” date on this page is when we last checked this educational summary against the electronic CFR—not the date of any VA policy or your personal claim decision.
Notes for your claim
Evidence: Show that your diagnosis and severity match the factors the schedule names for DC 7301 (e.g., measurements, frequency, treatment, functional loss), with medical and lay evidence as appropriate.
C&P exams: Results should reflect the schedule’s requirements (correct joints measured, correct formulas). If the exam omits required findings, consider submitting records or requesting clarification.
If you disagree with the DC, percentage, or effective date, review the Part 4 text for your period and consider a supplemental claim or appeal with a VA-accredited representative.
This site does not provide legal advice.
Official source
38 CFR Part 4 (eCFR) — locate diagnostic code 7301 in the subpart for your body system (use Find in Page if needed).
DC 7301 (adhesions of peritoneum) is one of the most commonly missed post-surgical secondaries — virtually any veteran with prior abdominal surgery (appendectomy, inguinal hernia repair, gallbladder, colorectal, gynecologic) can develop peritoneal adhesions, but most never file. The post-May-2024 § 4.114 restructure expanded the schedule significantly — now reaches 80% for persistent partial bowel obstruction inoperable or requiring TPN (up from 50% in legacy schedule). Tier ladder: 0% (history asymptomatic), 10% (any one specified symptom), 30% (symptoms + dietary modification), 50% (recurrent obstruction requiring annual hospitalization + dietary modification + symptoms), 80% (persistent partial obstruction either inoperable/refractory or requiring TPN). Tactical lane: post-surgical adhesions are direct secondary to ANY service-connected abdominal surgery — open the secondary file aggressively.
Rating Tiers — What Each Percentage Requires
| Rating | What It Takes | Evidence That Supports It |
|---|---|---|
| 80% | Persistent partial bowel obstruction that is either inoperable and refractory to treatment, OR requires total parenteral nutrition (TPN). | Surgical consult notes documenting inoperability; nutrition records showing TPN dependence; imaging confirming persistent partial obstruction. |
| 50% | Symptomatic adhesions with recurrent obstruction requiring hospitalization at least once yearly + dietary modification + specified symptoms. | Hospital admission records for SBO at least annually; documented dietary modification (low-residue, soft diet); chart documentation of symptoms (abdominal pain, distension, nausea, constipation, vomiting). |
| 30% | Symptomatic adhesions requiring dietary modification + specified symptoms. | Documented dietary modification + chart documentation of specified symptoms (abdominal pain, distension, nausea, constipation, vomiting). |
| 10% | Symptomatic adhesions with at least one specified symptom (abdominal pain, distension, nausea, constipation, vomiting). | Chart documentation of any one specified symptom attributable to adhesions. |
| 0% | History of peritoneal adhesions, currently asymptomatic. | Surgical history + imaging confirming adhesions but no current symptoms. |
What Qualifies Under DC 7301?
Peritoneal adhesions (post-surgical, post-infectious, post-traumatic)
Fibrous bands between abdominal organs and peritoneum. Etiologies: prior surgery (most common), prior peritonitis or PID, prior abdominal trauma, prior radiation.
Tier ladder driven by symptoms + treatment + complications (post-May-2024 § 4.114)
Updated schedule:
- • 0% — History only, asymptomatic
- • 10% — At least one specified symptom (pain, distension, nausea, constipation, vomiting)
- • 30% — Symptoms + dietary modification
- • 50% — Recurrent obstruction requiring annual hospitalization + dietary modification + symptoms
- • 80% — Persistent partial obstruction inoperable/refractory OR requires TPN
Direct secondary to SC abdominal surgery
Virtually any abdominal surgery causes adhesions to some degree. Hernia repair (DC 7338), gallbladder, appendectomy, colorectal, gynecologic, trauma all qualify as predicate.
Language Your Rater Needs to See
These are the exact (or near-exact) regulatory phrases that unlock specific tiers. If your DBQ or C&P report doesn't use this vocabulary, the rater may default to a lower percentage even when symptoms qualify.
“Persistent partial bowel obstruction — inoperable AND refractory to treatment, OR requires TPN”
80% gate. Two disjunctive paths: (1) surgical consult documents inoperability + refractoriness; (2) nutrition record shows TPN dependence. Either anchors 80%.
“Recurrent obstruction requiring hospitalization at least once yearly + dietary modification + specified symptoms”
50% gate. All three required: annual hospitalization for SBO + documented dietary modification + symptoms. Hospital admissions are the cleanest anchor.
“Symptoms + dietary modification (low-residue, soft diet, etc.)”
30% gate. Dietary modification specifically prescribed by a provider for adhesion symptoms. 'Avoid raw vegetables / nuts / popcorn / corn' is typical adhesion-management diet — get it in the chart.
“Any one specified symptom (abdominal pain, distension, nausea, constipation, vomiting)”
10% floor. ANY ONE specified symptom anchors the rating. Don't accept 0% for symptomatic adhesions.
Evidence Checklist — Specific to This Condition
Surgical history documenting prior abdominal surgery
CRITICALAnchors the etiology. Appendectomy, hernia repair, gallbladder, colorectal, gynecologic, trauma surgery — any prior abdominal surgery is the predicate.
Imaging confirming adhesions (CT, MRI, laparoscopy)
CRITICALAdhesions are best confirmed by direct visualization (laparoscopy) or CT enterography. Documents the anatomic basis.
Symptom diary — abdominal pain, distension, nausea, constipation, vomiting
CRITICALDrives the tier directly. Each symptom counts toward the 10%+ specified-symptom criteria.
Hospitalization records for SBO (small bowel obstruction)
CRITICALAnnual or more frequent SBO admissions anchor 50% gate. Pull each admission's discharge summary.
Dietary modification documentation
CRITICALProvider-prescribed dietary restriction (low-residue, soft diet, etc.) for adhesion management. Anchors 30%-50% tiers.
Nutrition records for TPN (if dependent)
IMPORTANTTPN dependence anchors 80% gate alone. Document via nutrition consult or home health.
Surgical consult assessing operability / refractoriness
IMPORTANTAnchors 80% gate (inoperable + refractory path).
C&P Exam Tips
Bring surgical history + imaging anchoring adhesions
Prior abdominal surgery + adhesion imaging anchors the diagnosis. Without these, the diagnosis is contested.
Bring symptom diary with each specified symptom documented
Abdominal pain, distension, nausea, constipation, vomiting. Each one counts. Document frequency, severity, triggers.
Bring SBO admission records if recurrent obstruction
Annual hospitalizations for SBO anchor 50% gate. Pull discharge summaries.
Bring dietary modification documentation
Provider-prescribed low-residue / soft diet for adhesion management anchors 30%+.
Don't minimize chronic abdominal symptoms
Many veterans normalize chronic adhesion pain. Describe specific examples — meals avoided, days off work, ER visits.
Common Mistakes That Cost Veterans Points
Never filing adhesions as a secondary to prior abdominal surgery
Virtually any veteran with prior abdominal surgery can develop peritoneal adhesions. Most never file. Open the secondary claim — direct secondary to SC abdominal surgery.
Settling for 10% when dietary modification supports 30%
Provider-prescribed dietary restriction (low-residue, soft diet) anchors 30% tier. Get the diet in writing.
Not pursuing 50% with annual SBO hospitalizations
At least one SBO admission per year + dietary modification + symptoms = 50%. Pull every SBO admission's discharge summary.
Missing 80% gate for TPN dependence or inoperable obstruction
Post-May-2024 § 4.114 restructure added 80% tier. TPN dependence alone OR inoperable + refractory obstruction = 80%. Higher ceiling than the legacy 50% cap.
Filing under wrong DC for related conditions
Adhesions = DC 7301. SBO without adhesions = consider other DCs. Endometriosis-related pelvic adhesions = DC 7629 (endometriosis). Match the etiology to the DC.
Tactical Plays
⚡ Open the secondary file aggressively after ANY SC abdominal surgery
Virtually any abdominal surgery causes peritoneal adhesions to some degree. Most veterans never file. If you have SC condition that required abdominal surgery (hernia repair DC 7338, gallbladder, appendectomy, colorectal, gynecologic, trauma) and have ANY abdominal symptoms post-op, open the DC 7301 secondary file. 10% floor is easy to anchor; higher tiers require documentation of dietary modification + SBO history.
⚡ Push for laparoscopic confirmation if imaging is equivocal
Adhesions are notoriously difficult to confirm on CT — they're often seen only at direct laparoscopy. If you have post-surgical abdominal symptoms but CT is negative, push for diagnostic laparoscopy. Direct visualization anchors the diagnosis definitively.
⚡ Document dietary modification in the chart — anchors 30%+
Many veterans self-modify diet (avoid raw vegetables, nuts, popcorn, corn) without provider documentation. Ask your gastroenterologist or PCP to chart the dietary restriction explicitly as adhesion management. Provider-prescribed dietary modification anchors 30% tier; without it, you cap at 10%.
⚡ Pursue 80% gate aggressively if TPN-dependent or inoperable
Post-May-2024 § 4.114 restructure added 80% tier. TPN dependence alone OR inoperable + refractory obstruction = 80%. This is a significantly higher ceiling than the legacy 50%. If you're TPN-dependent or have been told 'no more surgery,' the 80% rating is the goal.
Secondary Conditions to File With This One
Prior abdominal surgery (predicate condition)
STRONGAppendectomy, hernia repair (DC 7338), gallbladder, colorectal, gynecologic, trauma surgery. If the underlying SC condition required abdominal surgery, adhesions are direct secondary.
Recurrent small bowel obstruction
STRONGSBO from adhesions rates within DC 7301 itself (drives tier). Each obstruction episode documented.
Chronic abdominal pain syndrome
MODERATEPersistent adhesion pain may rate analogously under chronic pain framework. Document with pain management consult.
Malnutrition / weight loss (if severe)
MODERATESevere adhesions with TPN dependence cause malnutrition. May rate under nutritional disorder analog if applicable.
Depression / anxiety secondary to chronic GI condition
MODERATEDC 9434 / 9400
Chronic abdominal pain + recurrent hospitalizations + dietary restriction drive depression. Well-documented secondary.
Iron-deficiency anemia (if chronic GI bleeding from adhesions)
SITUATIONALDC 7720
Rare — severe adhesions with mucosal ulceration may cause occult bleeding. Rates separately under DC 7720.
Compensation Scenarios
2026 rates (effective Dec 1, 2025, per va.gov)
10% — single, no dependents
Base rating
$180.42
TOTAL
$180.42/mo
Any one specified symptom (e.g., chronic abdominal pain).
30% — single, no dependents
Base rating
$552.47
TOTAL
$552.47/mo
Symptoms + dietary modification.
50% — single, no dependents
Base rating
$1,132.90
TOTAL
$1,132.90/mo
Recurrent SBO requiring annual hospitalization + dietary modification + symptoms.
80% — single, no dependents
Base rating
$2,102.15
TOTAL
$2,102.15/mo
Persistent partial obstruction inoperable/refractory OR TPN-dependent.
Note: Amounts are approximations rounded to nearest dollar. Actual comp varies with effective date, dependents (spouse, children, parents — each adds), Aid & Attendance, and additional disabilities. Combined ratings use VA Math (§ 4.25), not simple addition.
Key Definitions
🔗What are Peritoneal Adhesions?
Peritoneal adhesions are fibrous bands of scar tissue that form between abdominal organs (intestines, omentum, peritoneal wall) after surgery, infection, trauma, or radiation. They can cause chronic abdominal pain, intermittent or persistent bowel obstruction, infertility (in pelvic adhesions), and dyspareunia. Up to 95% of patients develop some adhesions after major abdominal surgery.
💡Why are adhesions so commonly missed as a secondary claim?
Adhesions develop silently after surgery — symptoms may emerge months to years later. Many veterans normalize chronic post-surgical abdominal pain and never file. Imaging (CT) often misses adhesions; only direct laparoscopy reliably confirms. The clean tactical play: if you have ANY abdominal symptoms after SC abdominal surgery, open the DC 7301 secondary file.
🚨What's an SBO (small bowel obstruction)?
Small bowel obstruction occurs when adhesions kink, twist, or compress the small intestine, blocking passage of intestinal contents. Symptoms: severe abdominal pain, distension, vomiting, inability to pass stool/gas. Treatment ranges from NPO + NG decompression (partial obstruction, often resolves) to emergency surgery (complete obstruction, ischemia, perforation). Annual SBO admissions anchor 50% under DC 7301.
💯What anchors the 80% gate post-May-2024?
Two disjunctive paths: (1) persistent partial bowel obstruction that is INOPERABLE AND REFRACTORY to treatment (surgical consult documents both), OR (2) requires total parenteral nutrition (TPN). Either anchors 80%. This is a new ceiling — the legacy § 4.114 schedule capped DC 7301 at 50%.
How to File Your Claim
Document prior abdominal surgery as predicate
DD-214 + service treatment records OR post-service surgery records establishing the predicate.
Pull imaging or laparoscopy report confirming adhesions
CT or diagnostic laparoscopy. Push for laparoscopy if imaging is equivocal.
Build symptom diary + dietary modification documentation + SBO admission records
Drives the tier directly. Each specified symptom counts; dietary modification anchors 30%; annual SBO admissions anchor 50%.
File 21-526EZ specifying 'peritoneal adhesions (DC 7301)' as secondary to prior SC abdominal surgery
Cite the predicate SC condition explicitly.
Stack mental health + nutritional secondaries if applicable
Depression from chronic pain (DC 9434), anxiety (DC 9400), malnutrition (if severe).
Typical Claim Timeline
File initial claim
Day 0–7: Submit VA Form 21-526EZ with all medical evidence on file
VA acknowledges claim
Week 1–2: Receive confirmation letter and claim tracking number
C&P examination scheduled
Month 1–3: VA contracts an exam vendor and sends you appointment notice
Attend C&P exam
Bring your full evidence package; describe symptoms on your worst days, not your best
Decision & rating notice
Month 3–6: Decision letter with rating percentage and effective date
First payment & retro back pay
Within 15 days of decision; retroactive to claim date (or effective date if earlier)
Timeline varies by case complexity and VA regional office workload. Some claims resolve faster; others take longer.
Important Considerations
Direct secondary to ANY SC abdominal surgery
Virtually any abdominal surgery causes adhesions. Most veterans never file. Open the secondary aggressively.
Dietary modification anchors 30% — get it charted
Provider-prescribed low-residue / soft diet for adhesion management.
Post-May-2024 § 4.114 added 80% tier
TPN dependence OR inoperable/refractory obstruction = 80%. Significantly higher ceiling than legacy schedule.
SBO admissions are the cleanest 50% anchor
Annual SBO admissions + dietary modification + symptoms = 50%. Pull every discharge summary.
Related Tools & Resources
Frequently Asked Questions
Can I file peritoneal adhesions as a secondary to my service-connected hernia surgery?
Yes — peritoneal adhesions are a direct secondary to virtually any abdominal surgery, including hernia repair (DC 7338), appendectomy, gallbladder, colorectal, gynecologic, and trauma surgery. Up to 95% of patients develop some adhesions after major abdominal surgery. If you have SC abdominal surgery + ANY abdominal symptoms post-op, open the DC 7301 secondary file.
What if my CT scan doesn't show adhesions?
Adhesions are notoriously difficult to confirm on CT — they're often seen only at direct laparoscopy. If you have post-surgical abdominal symptoms but CT is negative, push your provider for diagnostic laparoscopy. Direct visualization anchors the diagnosis definitively. CT findings of partial bowel obstruction or transition points are also supportive even without visible bands.
How do I document dietary modification for the 30% tier?
Ask your gastroenterologist or PCP to chart the dietary restriction explicitly as adhesion management. Typical adhesion-management diet: avoid raw vegetables, nuts, seeds, popcorn, corn, fibrous fruits. Provider-prescribed dietary modification anchors 30% tier; without it, you cap at 10% even with multiple symptoms documented.
What's the new 80% tier post-May 2024?
The May 19, 2024 § 4.114 restructure added an 80% tier for DC 7301 — significantly higher than the legacy 50% ceiling. The 80% gate requires persistent partial bowel obstruction that is EITHER (1) inoperable AND refractory to treatment, OR (2) requires total parenteral nutrition (TPN). Surgical consult notes documenting inoperability + refractoriness OR nutrition records showing TPN dependence anchor 80%.
Does DC 7301 stack with my other GI condition ratings?
Per § 4.114, do NOT combine ratings under diagnostic codes 7301 through 7329 (and certain others) with each other — assign a single evaluation under the diagnostic code reflecting the predominant disability picture, elevated if warranted by overall severity. However, DC 7301 DOES stack with other digestive conditions outside that range (e.g., HCV under DC 7354, cirrhosis under DC 7312, mental health secondaries). Check the specific anti-pyramiding language for your DC combinations.
Official Regulatory Source
Peritoneal adhesions rate under 38 CFR § 4.114, DC 7301 — 0/10/30/50/80% based on symptoms + dietary modification + obstruction frequency + treatment requirement (post-May-2024 restructure).
38 CFR § 4.114 — Digestive System (eCFR) →Scroll to DC 7301. Note anti-pyramiding language for § 4.114 — don't combine with other DCs in the 7301-7329 range; elevate the predominant DC instead.
Next Steps
If your rating decision lists DC 7301, compare your current symptoms and documentation against the criteria above. Consider:
- Requesting a copy of your rating decision and C&P exam report from the VA
- Gathering all relevant medical records (VA and private providers)
- Documenting functional limitations and how they impact work and daily activities
- Obtaining a nexus letter if needed to establish or strengthen service connection
- Filing for secondary conditions that may be related to this primary condition
- Contacting a VA-accredited VSO, claims agent, or attorney to review your file
This is general educational information only — not legal or medical advice.
Also: DC code lookup (tools) lists the same index in a compact layout.
Source: 38 CFR Part 4, Diagnostic Code 7301 • va.gov
⚠️ Important Disclaimer
This page provides general educational information only based on public VA regulations (38 CFR) and va.gov resources. It is not legal, medical, or claims assistance. Ratings and service connections are decided case-by-case by the VA based on the individual veteran’s evidence. We do not prepare claims, generate documents, or provide personalized advice. Always consult a VA-accredited Veterans Service Organization (VSO), attorney, or your physician for help with your specific situation. Verify the latest rules on va.gov.