Episodes are counted, and the definition is narrow
Diagnostic codes 6510 through 6514 share a General Rating Formula in §4.97:
| Level | Criterion |
|---|---|
| 50% | Following radical surgery with chronic osteomyelitis, or near-constant sinusitis characterized by headaches, pain and tenderness |
| 30% | Three or more incapacitating episodes per year requiring prolonged antibiotics, or more than six non-incapacitating episodes per year |
| 10% | One or two incapacitating episodes per year, or three to six non-incapacitating episodes per year |
| 0% | Detected by X-ray only |
"Incapacitating episode" means something specific
The formula's note defines it: an episode that requires bed rest and treatment by a physician.
Both halves. A week of feeling terrible is not an incapacitating episode under this rule; neither is a bad stretch you worked through, however genuinely bad it was. Converting ordinary awful days into regulatory episodes produces a count that falls apart when the records are read, and the records will be read.
Count them accurately and record both kinds separately — non-incapacitating episodes have their own thresholds, and six of those reaches the same 30% as three incapacitating ones.
What to document
Dates of each episode, what treatment was given, whether antibiotics were prescribed and for how long, and whether a physician directed rest. Any surgical history, with operative reports. Imaging and endoscopy findings.
Note the 50% level's first route: it concerns radical surgery with chronic osteomyelitis, which is a narrow and serious combination. Prior sinus surgery alone does not reach it.
The ENT DBQ collects the clinical findings. Overlapping nasal diagnoses need a §4.14 analysis before assuming separate evaluations.
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Reviewed October 6, 2026