The schedule changed, and most summaries did not
The digestive rating schedule was revised effective 19 May 2024. If you are reading a guide that rates GERD on how often you get heartburn and whether it disturbs your sleep, you are reading the previous schedule.
Under the current §4.114, DC 7206, GERD is rated on esophageal stricture criteria:
| Level | Criterion |
|---|---|
| 80% | Recurrent or refractory stricture with dysphagia, plus aspiration, undernutrition and/or substantial weight loss, requiring surgical correction or PEG tube |
| 50% | Recurrent or refractory stricture requiring dilatation three or more times per year, annual steroid-assisted dilatation, or stent placement |
| 30% | Recurrent stricture requiring dilatation no more than twice per year |
| 10% | Stricture requiring daily medication to control dysphagia |
| 0% | No daily symptoms and no daily medication requirement |
Two definitions and a documentation requirement
The notes define the terms the schedule turns on. Recurrent means inability to maintain target esophageal diameter beyond four weeks after it was achieved. Refractory means inability to achieve target diameter despite no fewer than five dilatation sessions at two-week intervals.
And findings must be documented by barium swallow, computerized tomography, or esophagogastroduodenoscopy. Symptom reports do not substitute.
What follows for evidence
Endoscopy and imaging reports with dates. Every dilatation, dated, with the method. Medication and whether it is daily. Weight over time. Any surgical intervention or feeding tube.
If no stricture has been documented, that is the finding to discuss with your clinician — not because you should seek a diagnosis, but because the current schedule is built around it, and evidence aimed at the old criteria will not reach the new ones.
For a rating period before 19 May 2024, the earlier text may apply. See when criteria change.
Rules and forms change, and exceptions apply. Follow the instructions on your own decision letter and the linked governing sources. This site does not track your deadlines or file anything for you.
Reviewed October 6, 2026