Hypersensitivity pneumonitis (extrinsic allergic alveolitis)

Description Percentage

Forced Vital Capacity (FVC) less than 50-percent predicted, or; Diffusion Capacity of the Lung for Carbon Monoxide by the Single Breath Method (DLCO (SB)) less than 40-percent predicted, or; maximum exercise capacity less than 15 ml/kg/min oxygen consumption with cardiorespiratory limitation, or; cor pulmonale or pulmonary hypertension, or; requires outpatient oxygen therapy

100
Description Percentage

FVC of 50- to 64-percent predicted, or; DLCO (SB) of 40- to 55-percent predicted, or; maximum exercise capacity of 15 to 20 ml/kg/min oxygen consumption with cardiorespiratory limitation

60
Description Percentage

FVC of 65- to 74-percent predicted, or; DLCO (SB) of 56- to 65-percent predicted

30
Description Percentage

FVC of 75- to 80-percent predicted, or; DLCO (SB) of 66- to 80-percent predicted

10





General Rating Formula for Interstitial Lung Disease (diagnostic codes 6825 through 6833): 

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