VA Disability Rating for Nontuberculous Mycobacterium Infection (DC 6312)
Diagnostic Code 6312 · 38 CFR §4.88b
What Is It?
Nontuberculous mycobacterium (NTM) infections are caused by mycobacteria species other than tuberculosis, such as Mycobacterium avium complex (MAC), M. kansasii, and M. abscessus. These bacteria are found in soil, water, and dust. NTM infections most commonly affect the lungs but can also involve skin, soft tissues, bones, joints, and lymph nodes. They are often chronic and difficult to treat. The VA rates active NTM infection at 100 percent with a mandatory re-examination after treatment. Recurrence must be confirmed by culture, histopathology, or other diagnostic testing. Residual damage to skin, respiratory, CNS, musculoskeletal, ocular, GI, and genitourinary systems is rated under appropriate body system codes.
Rating Criteria
| Rating | Criteria |
|---|---|
| 100% | Active NTM infection confirmed by culture, histopathology, or other diagnostic testing during treatment. The 100 percent rating continues for the duration of treatment, followed by a mandatory VA examination. |
| 0% | No relapse confirmed on follow-up. Residual damage to skin, respiratory, CNS, musculoskeletal, ocular, GI, or genitourinary systems is rated under appropriate body system codes and section 4.88c residuals. |
Evidence Needed
Positive mycobacterial culture identifying the NTM species. CT imaging showing disease pattern. Sputum cultures over time. Treatment records documenting multi-drug regimen. Post-treatment imaging and pulmonary function tests.
C&P Exam Tips
Bring culture results identifying the NTM species. Have CT scans from before, during, and after treatment. Get pulmonary function tests if lungs affected. Describe ongoing respiratory symptoms. Document extrapulmonary involvement.
How to File
File under DC 6312 during active infection. After treatment, the VA conducts a mandatory examination. File for residual damage under appropriate body system codes, especially lung damage such as bronchiectasis.
Common Mistakes
The biggest mistake is confusing NTM with tuberculosis — they are different organisms rated under different codes. Other mistakes include failing to get follow-up imaging, not claiming bronchiectasis separately, and not realizing NTM can recur.
Frequently Asked Questions
How is NTM different from tuberculosis?
NTM infections are caused by different mycobacteria species. They are not transmitted person-to-person and are acquired from environmental sources. They tend to be more chronic and harder to cure.
Can NTM infections come back after treatment?
Yes. NTM infections have a significant recurrence rate. Recurrence must be confirmed by culture, histopathology, or other diagnostic testing.
What residual lung damage does NTM cause?
NTM can cause bronchiectasis, pulmonary fibrosis, cavitary disease, and nodular disease — all permanent structural changes that reduce lung function.