C-Cell Hyperplasia of the Thyroid — VA Rating (DC 7919)

Diagnostic Code 7919 · 38 CFR §4.119

What Is It?

C-cell hyperplasia is an overgrowth of parafollicular C-cells in the thyroid gland. These cells produce calcitonin, a hormone involved in calcium regulation. The condition is significant because it can be a precursor to medullary thyroid cancer (MTC). It may be found incidentally during thyroid surgery or identified through elevated calcitonin levels. Veterans may develop this condition from radiation exposure to the neck during service or as part of genetic syndromes (particularly MEN2) triggered by environmental exposures.

Rating Criteria

RatingCriteria
See pathways%DC 7919 has no native percentage scale. The VA directs evaluation to one of two pathways depending on treatment: (1) If antineoplastic therapy (cancer treatment) is required, evaluate as a malignant neoplasm under DC 7914 — 100% mandatory during active treatment, six-month carryover, then residuals. (2) If no antineoplastic therapy is required, evaluate as a benign neoplasm under DC 7915 — by the hormonal effects (thyroid dysfunction under DC 7900/7903, hypocalcemia, etc.).

Evidence Needed

Pathology reports showing C-cell hyperplasia (usually from a thyroid biopsy or surgical specimen) confirm the diagnosis. Calcitonin blood levels that are elevated support the diagnosis. If thyroidectomy was performed, surgical and pathology reports document the treatment. Genetic testing results (RET proto-oncogene) may be relevant for determining whether prophylactic thyroidectomy was appropriate. Radiation exposure records from service connect the condition to military service.

Frequently Asked Questions

Is C-cell hyperplasia the same as thyroid cancer?

No, but it is considered a precursor condition. C-cell hyperplasia is an overgrowth of cells that may progress to medullary thyroid cancer over time. If antineoplastic therapy is needed, it is rated as cancer under DC 7914. If a prophylactic thyroidectomy is performed to prevent cancer, the resulting hypothyroidism is rated under DC 7903.

Why would the VA remove the thyroid for a non-cancerous condition?

Prophylactic thyroidectomy may be recommended when C-cell hyperplasia has a high risk of progressing to medullary thyroid cancer, particularly in patients with genetic mutations (RET gene). The resulting hypothyroidism is rated under DC 7903 — initially 30% for six months, then residuals are rated under appropriate body system codes.