2026 ICD-10-CM Diagnosis Code Q36.9Cleft lip, unilateral
ICD-10-CM Codes›Q00-Q99›Q35-Q37›Q36
- Billable — Valid for Submission
- POA Exempt
- Chronic Condition
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 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
Code Classification
Present on Admission (POA)Billing
Q36.9 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.
- 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
These terms are the conditions for which that code is to be used. The terms may be synonyms of the code title, or, in the case of "other specified" codes, the terms are a list of the various conditions assigned to that code. The inclusion terms are not necessarily exhaustive. Additional terms found only in the Alphabetic Index may also be assigned to a code.
Index to Diseases and InjuriesGuidance
Alphabetical index entries that point to this code.
Cleft (congenital) See Also: Imperfect, closure;
lip (unilateral) Q36.9
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
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.
Code HistoryHistory
Questions About Q36.9Overview
What is the ICD-10 code for cleft lip, unilateral?
The ICD-10-CM code for cleft lip, unilateral is Q36.9 (sometimes written as Q369). It is billable on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
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 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 Q36.9 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. 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 Q36.9?
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.
