2026 ICD-10-CM Diagnosis Code Q35.5Cleft hard palate with cleft soft palate

ICD-10-CM Codes›Q00-Q99›Q35-Q37›Q35

ICD-10-CM Q35.5
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

Q35.5 is a billable ICD-10-CM diagnosis code for cleft hard palate with cleft soft palate. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026) and groups to MS-DRG 11 through 13, 157 through 159. The code is exempt from POA reporting. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Cleft lip or palate.

Code Identity

ICD-10-CM Code
Q35.5
Billable Status
Yes — Valid for Submission
Code Describes
Cleft hard palate with cleft soft palate
Short Description
Cleft hard palate with cleft soft palate
Same as the full description in the CMS dataset.
Parent Code
Q35
Cleft palate

Code Classification

ChapterQ00-Q99Congenital malformations, deformations and chromosomal abnormalities
SectionQ35-Q37Cleft lip and cleft palate
CategoryQ35Cleft palate
This CodeQ35.5Cleft hard palate with cleft soft palate

Present on Admission (POA)Billing

Q35.5 is exempt from POA reporting on inpatient claims to general acute care hospitals. Review the other POA exempt codes in Cleft lip and cleft palate (Q35-Q37).

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Central complete cleft palate
  • Central incomplete cleft palate
  • Cleft hard and soft palate
  • Cleft hard palate, bilateral
  • Cleft of left hard palate
  • Cleft of right hard palate
  • Cleft soft palate, bilateral
  • Complete bilateral cleft palate
  • Complete cleft hard and soft palate
  • Complete cleft of hard palate
  • Complete cleft of left hard and soft palate
  • Complete cleft of right hard and soft palate
  • Complete cleft of soft palate
  • Incomplete cleft hard and soft palate
  • Incomplete cleft palate
  • Occult submucous cleft palate
  • Submucous cleft of hard palate
  • Submucous cleft palate

Index to Diseases and InjuriesGuidance

Alphabetical index entries that point to this code.

Clinical ClassificationClinical

AHRQ’s CCSR groups this code into broader clinical categories.

CCSR MAL006
Cleft lip or palate
Default principal diagnosis: inpatient Yes · outpatient Yes

Clinical InformationClinical

  • Cleft Palate

    congenital fissure of the soft and/or hard palate, due to faulty fusion.

  • Palatal Obturators

    appliances that close a cleft or fissure of the palate.

  • Cleft Palate

    a congenital abnormality consisting of a fissure in the midline of the hard and/or soft palate; it is the result of the failure of the two sides of the palate to fuse during embryonic development.

  • Palatorrhaphy|Cleft Palate Repair|Cleft palate repair

    the surgical repair of a cleft palate by approximation of the intact tissues surrounding the defect.

  • TBX22 wt Allele|ABERS|CLPA|CPX|Cleft Palate and/or Ankyloglossia Gene|T-Box 22 wt Allele|TBXX|dJ795G23.1

    human tbx22 wild-type allele is located in the vicinity of xq21.1 and is approximately 21 kb in length. this allele, which encodes t-box transcription factor tbx22 protein, plays a role in palate development. mutation of the gene is associated with x-linked cleft palate and ankyloglossia.

Patient EducationClinical

Cleft Lip and Palate

Cleft lip and cleft palate are birth defects that occur when a baby's lip or mouth do not form properly. They happen early during pregnancy. A baby can have a cleft lip, a cleft palate, or both.

Read the full article at MedlinePlus

Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.

Convert Q35.5 to ICD-9-CMHistory

The closest ICD-9-CM equivalents under the General Equivalence Mappings.

ICD-9-CM
749.00 Cleft palate NOS
Approximate The match is approximate rather than exact.

Code HistoryHistory

FY 2016AddedAdded to the ICD-10-CM code setEffective October 1, 2015, the first year of ICD-10-CM.
FY 2017–2025No changes
FY 2026CurrentCurrent code set, no changesEffective October 1, 2025 through September 30, 2026.

Questions About Q35.5Overview

What is the ICD-10 code for cleft hard palate with cleft soft palate?

The ICD-10-CM code for cleft hard palate with cleft soft palate is Q35.5 (sometimes written as Q355). It is billable on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

Is Q35.5 (Cleft palate) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report cleft hard palate with cleft soft palate on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

What MS-DRG does Q35.5 group to?

When cleft hard palate with cleft soft palate is the principal diagnosis on an inpatient stay, it groups to MS-DRG 11, 12, 13, 157, 158, 159, with relative weights from 0.7085 to 5.4541 depending on complications. Higher weights mean higher Medicare reimbursement.

Is Q35.5 exempt from POA reporting?

Yes. CMS lists this code among those exempt from present on admission reporting, so hospitals do not assign a POA indicator for cleft hard palate with cleft soft palate on inpatient claims. The code appears in the Cleft lip and cleft palate (Q35-Q37) range of the CMS exempt list.

What is the ICD-9 equivalent of Q35.5?

Under the General Equivalence Mappings, cleft hard palate with cleft soft palate converts to ICD-9-CM 749.00 (cleft palate NOS). The mapping is approximate, so confirm the match fits the documentation.