2026 ICD-10-CM Diagnosis Code Q36.9Cleft lip, unilateral

ICD-10-CM Codes›Q00-Q99›Q35-Q37›Q36

ICD-10-CM Q36.9
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

Q36.9 is a billable ICD-10-CM diagnosis code for cleft lip, unilateral. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026) and groups to MS-DRG 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
Q36.9
Billable Status
Yes — Valid for Submission
Code Describes
Cleft lip, unilateral
Short Description
Cleft lip, unilateral
Same as the full description in the CMS dataset.
Parent Code
Q36
Cleft lip

Code Classification

ChapterQ00-Q99Congenital malformations, deformations and chromosomal abnormalities
SectionQ35-Q37Cleft lip and cleft palate
CategoryQ36Cleft lip
This CodeQ36.9Cleft lip, unilateral

Present on Admission (POA)Billing

Q36.9 is exempt from POA reporting on inpatient claims to general acute care hospitals. Review other POA exempt codes.

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Auricular abnormality, cleft lip, ocular abnormality syndrome
  • Cleft lip
  • Cleft lip and cleft of alveolar process of maxilla
  • Cleft lip retinopathy syndrome
  • Cleft lip sequence
  • Complete cleft lip
  • Complete left cleft lip
  • Complete left cleft lip and complete cleft of left alveolar process of maxilla
  • Complete right cleft lip
  • Complete right cleft lip and complete cleft of right alveolar process of maxilla
  • Incomplete cleft lip
  • Incomplete left cleft lip
  • Incomplete left cleft lip and incomplete cleft of left alveolar process of maxilla
  • Incomplete right cleft lip
  • Incomplete right cleft lip and incomplete cleft of right alveolar process of maxilla
  • Isolated cleft lip
  • Left cleft lip
  • Microbrachycephaly, ptosis, cleft lip syndrome
  • Right cleft lip
  • Verloove Vanhorick Brubakk syndrome

Tabular List NotesGuidance

Coding notes and annotation back-references applicable to this code.

Inclusion Terms

  • Cleft lip NOS

Index to Diseases and InjuriesGuidance

Alphabetical index entries that point to this code.

External Cause of Injuries IndexGuidance

References for this code in the External Cause of Injuries Index.

    • Cleft(congenital)
      • lip (unilateral)

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 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

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

Convert Q36.9 to ICD-9-CMHistory

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

ICD-9-CM
749.10 Cleft lip NOS
Approximate The match is approximate rather than exact.
ICD-9-CM
749.11 Unilat cleft lip-compl
Approximate The match is approximate rather than exact.
ICD-9-CM
749.12 Unilat cleft lip-imcompl
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 Q36.9Overview

Is Q36.9 (Cleft lip) a billable code?

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

What MS-DRG does Q36.9 group to?

When cleft lip, unilateral is the principal diagnosis on an inpatient stay, it groups to MS-DRG 157, 158, 159, with relative weights from 0.7085 to 1.7168 depending on complications. Higher weights mean higher Medicare reimbursement.

Is Q36.9 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, unilateral on inpatient claims.

What is the ICD-9 equivalent of Q36.9?

Under the General Equivalence Mappings, cleft lip, unilateral converts to ICD-9-CM 749.10 (cleft lip NOS), 749.11 (unilat cleft lip-compl), and 749.12 (unilat cleft lip-imcompl). The mapping is approximate, so confirm the match fits the documentation.

Footnotes

[1] Chronic - a chronic condition code indicates a condition lasting 12 months or longer and its effect on the patient based on one or both of the following criteria:

  • The condition results in the need for ongoing intervention with medical products,treatment, services, and special equipment
  • The condition places limitations on self-care, independent living, and social interactions.