2026 ICD-10-CM Diagnosis Code Q36.1Cleft lip, median
ICD-10-CM Codes›Q00-Q99›Q35-Q37›Q36
- Billable — Valid for Submission
- POA Exempt
- Chronic Condition
Q36.1 is a billable ICD-10-CM diagnosis code for cleft lip, median. 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. Coders also document this condition as central cleft lip. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Cleft lip or palate.
Code Identity
Code Classification
Present on Admission (POA)Billing
Q36.1 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 cleft lip
- Familial median cleft of upper and lower lip
- Frontonasal dysplasia sequence
- Lipoma of brain
- Median cleft lip and cleft of alveolar process of maxilla
- Midline cleft of lower lip
- Pai syndrome
Index to Diseases and InjuriesGuidance
Alphabetical index entries that point to this code.
Cleft (congenital) See Also: Imperfect, closure;
median Q36.1
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Clinical InformationClinical
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.
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
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Convert Q36.1 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About Q36.1Overview
What is the ICD-10 code for cleft lip, median?
The ICD-10-CM code for cleft lip, median is Q36.1 (sometimes written as Q361). It is billable on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
Is Q36.1 (Cleft lip) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report cleft lip, median on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
What MS-DRG does Q36.1 group to?
When cleft lip, median 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 Q36.1 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 lip, median 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 Q36.1?
Under the General Equivalence Mappings, cleft lip, median converts to ICD-9-CM 749.11 (unilat cleft lip-compl). The mapping is approximate, so confirm the match fits the documentation.
