Not Valid for Submission
Q36 is a "header" nonspecific and non-billable diagnosis code code, consider using a code with a higher level of specificity for a diagnosis of cleft lip. The code is NOT valid for the year 2021 for the submission of HIPAA-covered transactions. Category or Header define the heading of a category of codes that may be further subdivided by the use of 4th, 5th, 6th or 7th characters.
Specific Coding for Cleft lip
Header codes like Q36 require more digits to indicate the appropriate level of specificity. Consider using any of the following ICD-10 codes with a higher level of specificity when coding for cleft lip:
Tabular List of Diseases and Injuries
The Tabular List of Diseases and Injuries is a list of ICD-10 codes, organized "head to toe" into chapters and sections with guidance for inclusions, exclusions, descriptions and more. The following references are applicable to the code Q36:
This note appears immediately under a three character code title to further define, or give examples of, the content of the category.
- congenital fissure of lip
- labium leporinum
Type 1 ExcludesType 1 Excludes
A type 1 excludes note is a pure excludes note. It means "NOT CODED HERE!" An Excludes1 note indicates that the code excluded should never be used at the same time as the code above the Excludes1 note. An Excludes1 is used when two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition.
- cleft lip with cleft palate Q37
- CLEFT LIP-. congenital defect in the upper lip where the maxillary prominence fails to merge with the merged medial nasal prominences. it is thought to be caused by faulty migration of the mesoderm in the head region.
Information for Patients
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.
A cleft lip happens if the tissue that makes up the lip does not join completely before birth. This causes an opening in the upper lip. The opening can be a small slit or a large opening that goes through the lip into the nose. It can be on one or both sides of the lip or, rarely, in the middle of the lip.
Children with a cleft lip also can have a cleft palate. The roof of the mouth is called the "palate." With a cleft palate, the tissue that makes up the roof of the mouth does not join correctly. Babies may have both the front and back parts of the palate open, or they may have only one part open.
Children with a cleft lip or a cleft palate often have problems with feeding and talking. They also might have ear infections, hearing loss, and problems with their teeth.
Often, surgery can close the lip and palate. Cleft lip surgery is usually done before age 12 months, and cleft palate surgery is done before 18 months. Many children have other complications. They may need additional surgeries, dental and orthodontic care, and speech therapy as they get older. With treatment, most children with clefts do well and lead a healthy life.
Centers for Disease Control and Prevention
- Cleft lip and palate (Medical Encyclopedia)
- Cleft lip and palate repair (Medical Encyclopedia)
- Cleft lip and palate repair - discharge (Medical Encyclopedia)