Maxilla or mandible, chronic osteomyelitis, osteonecrosis or osteoradionecrosis of (DC 9900)

Rating levels

• -1% — Chronic osteomyelitis, osteonecrosis, or osteoradionecrosis of the maxilla or mandible is rated using the same 5-tier ladder as osteomyelitis at any other bone (DC 5000). Apply the criteria below to the jaw bone the same way they would be applied to any other bone: count discharging sinuses, sequestrum or involucrum on imaging, and active-infection windows. Osteoradionecrosis of the jaw is a known complication of head-and-neck radiation therapy; if it is service-connected secondary to such treatment, it is rated under this code.
• 100% — The 100% tier of DC 5000 is written for axial and appendicular bone (pelvis, vertebrae, hip, knee, shoulder, etc.) and rarely applies to maxilla/mandible disease in isolation. It is reachable from DC 9900 only when the jaw disease is part of multifocal osteomyelitis or has produced systemic constitutional symptoms (anemia, amyloid liver changes, debility) along with a long history of intractability.
• 60% — You qualify for 60% if you have frequent flare-ups of jaw osteomyelitis, osteonecrosis, or osteoradionecrosis AND those flare-ups produce constitutional symptoms (fever, chills, fatigue, loss of appetite, malaise that affects the whole body, not just local jaw pain or swelling).
• 30% — You qualify for 30% if imaging or surgical findings show definite involucrum (new bone forming around the dead, infected jawbone) or sequestrum (pieces of dead jawbone separating from healthy bone), with or without a discharging sinus draining from the jaw to the mouth or skin. This is a common rating tier for chronic jaw osteoradionecrosis after head-and-neck radiation.
• 20% — You qualify for 20% if you have or have had a discharging sinus from the maxilla or mandible (a tract draining pus/fluid into the mouth or through the skin) or other evidence of active jaw-bone infection at any point during the past 5 years. The infection does not need to be active right now; documented active-infection evidence within the 5-year window is enough.
• 10% — You qualify for 10% if you have a history of repeated episodes of jaw-bone infection or osteonecrosis but the disease has been inactive (no discharging sinus, no fevers, no imaging evidence of progression) for at least 5 years. This is the maintenance floor for a service-connected jaw-bone condition that has burned itself out.