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7328
§ 4.114 Schedule of ratings—digestive system.

Small intestine cancer

Malignant tumor of the small intestine

What the rating means

VA rates small intestine resection under diagnostic code 7328, which covers removal of part or all of the small intestine. Possible ratings are 0%, 20%, 40%, 60%, and 80%. The regulation notes this code includes short bowel syndrome, mesenteric ischemic thrombosis, and post-bariatric surgery complications.

A 0% rating applies when you have had the resection but have no symptoms. A 20% rating applies when you have four or more episodes of diarrhea per day. A 40% rating requires those same four or more daily diarrhea episodes together with undernutrition and anemia, managed with prescribed oral dietary supplementation and continuous medication. A 60% rating requires undernutrition and anemia controlled with prescribed oral dietary supplementation, continuous medication, and intermittent total parenteral nutrition. An 80% rating requires undernutrition and anemia that can only be managed with total parenteral nutrition.

VA will not combine this rating with other digestive system ratings under codes 7301 through 7329 and certain others. When more than one of those codes applies, VA assigns a single rating under whichever code best reflects the overall disability, raising it one level if the full severity warrants it.

Evidence that helps

Medical records documenting that the resection took place form the foundation of any claim under this code. For a 20% rating, records showing the frequency of diarrhea episodes — such as gastroenterology notes or a symptom diary reviewed by a clinician — are relevant.

For a 40% rating, you would also need evidence of undernutrition and anemia. Lab results showing low albumin, prealbumin, or other nutritional markers, along with a complete blood count showing anemia, directly support those criteria. Prescription records confirming oral dietary supplementation and continuous medication tie the treatment to the rating level.

For 60%, records must additionally show that intermittent total parenteral nutrition has been prescribed and used. For 80%, documentation must show that total parenteral nutrition is required on an ongoing basis. Physician or dietitian notes explaining why TPN is necessary, infusion pharmacy records, and treatment plans all help establish this. Statements from you or those who care for you describing how symptoms affect eating, daily activities, and the ability to work can help show the overall severity of the condition.

Secondary conditions

Conditions that are often caused or made worse by this one. If you have any of these, they may be claimable as secondary service connection.