ICD-10-CM Code Q38.0

Congenital malformations of lips, not elsewhere classified

Version 2020 Billable Code POA Exempt

Valid for Submission

Q38.0 is a billable code used to specify a medical diagnosis of congenital malformations of lips, not elsewhere classified. The code is valid for the year 2020 for the submission of HIPAA-covered transactions. The ICD-10-CM code Q38.0 might also be used to specify conditions or terms like aberrant insertion of labial frenulum, broad attachment of labial frenum, caliber persistent labial artery, congenital anomaly of lip, congenital anomaly of oral mucosa, congenital commissural pits, etc The code is exempt from present on admission (POA) reporting for inpatient admissions to general acute care hospitals.

ICD-10:Q38.0
Short Description:Congenital malformations of lips, not elsewhere classified
Long Description:Congenital malformations of lips, not elsewhere classified

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 Q38.0:

Inclusion Terms

Inclusion Terms
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.
  • Congenital fistula of lip
  • Congenital malformation of lip NOS
  • Van der Woude's syndrome

Type 1 Excludes

Type 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 Q36
  • cleft lip with cleft palate Q37
  • macrocheilia Q18.6
  • microcheilia Q18.7

Index to Diseases and Injuries

The Index to Diseases and Injuries is an alphabetical listing of medical terms, with each term mapped to one or more ICD-10 code(s). The following references for the code Q38.0 are found in the index:


Synonyms

The following clinical terms are approximate synonyms or lay terms that might be used to identify the correct diagnosis code:

  • Aberrant insertion of labial frenulum
  • Broad attachment of labial frenum
  • Caliber persistent labial artery
  • Congenital anomaly of lip
  • Congenital anomaly of oral mucosa
  • Congenital commissural pits
  • Congenital double lip
  • Congenital ectropion of lip
  • Congenital fistula of lip
  • Congenital hyperplasia of sebaceous glands of lip
  • Congenital lip pits
  • Congenital lower lip pits
  • Diprosopus
  • Enlarged labial frenum
  • Finding of arrangement of lip
  • Fistula of lip
  • High upper lip line
  • Ichthyosis, alopecia, eclabion, ectropion, intellectual disability syndrome
  • Lamellar ichthyosis
  • Median nodule of upper lip
  • Midline sinus of the upper lip
  • Synchilia
  • Van der Woude syndrome

Present on Admission (POA)

Q38.0 is exempt from POA reporting - The Present on Admission (POA) indicator is used for diagnosis codes included in claims involving inpatient admissions to general acute care hospitals. POA indicators must be reported to CMS on each claim to facilitate the grouping of diagnoses codes into the proper Diagnostic Related Groups (DRG). CMS publishes a listing of specific diagnosis codes that are exempt from the POA reporting requirement. Review other POA exempt codes here .

CMS POA Indicator Options and Definitions
POA Indicator CodePOA Reason for CodeCMS will pay the CC/MCC DRG?
YDiagnosis was present at time of inpatient admission.YES
NDiagnosis was not present at time of inpatient admission.NO
UDocumentation insufficient to determine if the condition was present at the time of inpatient admission.NO
WClinically undetermined - unable to clinically determine whether the condition was present at the time of inpatient admission.YES
1Unreported/Not used - Exempt from POA reporting. NO

Convert Q38.0 to ICD-9

  • 750.25 - Congenital lip fistula (Approximate Flag)

Code Classification

  • Congenital malformations, deformations and chromosomal abnormalities (Q00-Q99)
    • Other congenital malformations of the digestive system (Q38-Q45)
      • Other congenital malformations of tongue, mouth and pharynx (Q38)

Code History

  • FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016
    (First year ICD-10-CM implemented into the HIPAA code set)
  • FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
  • FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
  • FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
  • FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020

Information for Patients


Birth Defects

A birth defect is a problem that happens while a baby is developing in the mother's body. Most birth defects happen during the first 3 months of pregnancy. One out of every 33 babies in the United States is born with a birth defect.

A birth defect may affect how the body looks, works or both. Some birth defects like cleft lip or neural tube defects are structural problems that can be easy to see. To find others, like heart defects, doctors use special tests. Birth defects can range from mild to severe. Causes can include

  • Genetics
  • Exposures to medicines or chemicals. For example, alcohol abuse can cause fetal alcohol syndrome.
  • Infections during pregnancy
  • Certain medicines. Before you get pregnant, talk to your health care provider about any medicines you take.
  • Not getting enough of certain nutrients. For example, not getting enough folic acid before and during pregnancy is a key factor in causing neural tube defects.

For most birth defects, the cause is unknown.

Health care providers can diagnose certain birth defects during pregnancy, with prenatal tests. That's why it important to get regular prenatal care. Other birth defects may not be found until after the baby is born. Sometimes the defect is obvious right away. Other times, the health care provider may not discover it until later in life.

Babies with birth defects often need special care and treatments. The treatments may include surgery, medicines, assistive devices, and therapies.

Centers for Disease Control and Prevention


[Learn More]

Mouth Disorders

Your mouth is one of the most important parts of your body. It has many different functions. It allows you to

  • Take in food and drink
  • Breathe in air
  • Start digestion, with your teeth chewing the food you eat and your salivary glands releasing saliva to help break down the food
  • Speak and sing
  • Show emotion, by smiling or pouting

Any problem that affects your mouth can make it hard to eat, drink, or even smile. Some common mouth problems include

  • Cold sores - painful sores on the lips and around the mouth, caused by a virus
  • Canker sores - painful sores in the mouth, caused by bacteria or viruses
  • Thrush - a yeast infection that causes white patches in your mouth
  • Leukoplakia - white patches of excess cell growth on the cheeks, gums or tongue, common in smokers
  • Dry mouth - a lack of enough saliva, caused by some medicines and certain diseases
  • Gum or tooth problems
  • Bad breath

Treatment for mouth disorders varies, depending on the problem. If a mouth problem is caused by some other disease, treating that disease can help. It is also important to keep your mouth clean and healthy by brushing, flossing, and not using tobacco.


[Learn More]