2026 ICD-10-CM Diagnosis Code Q38.6Other congenital malformations of mouth

ICD-10-CM Codes›Q00-Q99›Q38-Q45›Q38

ICD-10-CM Q38.6
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

Q38.6 is a billable ICD-10-CM diagnosis code for other congenital malformations of mouth. 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 Digestive congenital anomalies.

Code Identity

ICD-10-CM Code
Q38.6
Billable Status
Yes — Valid for Submission
Code Describes
Other congenital malformations of mouth
Short Description
Other congenital malformations of mouth
Same as the full description in the CMS dataset.
Parent Code
Q38
Other congenital malformations of tongue, mouth and pharynx

Code Classification

ChapterQ00-Q99Congenital malformations, deformations and chromosomal abnormalities
SectionQ38-Q45Other congenital malformations of the digestive system
CategoryQ38Other congenital malformations of tongue, mouth and pharynx
This CodeQ38.6Other congenital malformations of mouth

Present on Admission (POA)Billing

Q38.6 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.

  • Brachymesophalangia
  • Buccal bifurcation cyst
  • Cleft palate lateral synechia syndrome
  • Congenital abnormality of oral cavity
  • Congenital absence of mouth
  • Congenital anomaly of mouth
  • Congenital anomaly of oral mucosa
  • Congenital malformation of tongue, mouth and pharynx
  • Cyst of oral soft tissue
  • Ectopic oral gastrointestinal cyst
  • Facial milia, lobate tongue, lingual and labial frenula syndrome
  • Fordyce spots of buccal mucosa
  • Fordyce spots of lips
  • Fordyce's disease
  • Frenal tag
  • Gingival odontogenic cyst
  • Hereditary mucoepithelial dysplasia
  • Hypertrichosis with congenital macrogingivae
  • Ichthyosis, oral and digital anomalies syndrome
  • Inflammatory odontogenic cyst
  • Melanin pigmentation of oral mucosa
  • Melanosis of mucosa of body orifice
  • Nail and tooth abnormalities, marginal palmoplantar keratoderma, oral hyperpigmentation syndrome
  • Oral-facial-digital syndrome with short stature and brachymesophalangia
  • Orofacial cleft
  • Oro-facial digital syndrome type 11
  • Oro-facial digital syndrome type 14
  • Oro-facial digital syndrome type 5
  • Wellesley Carman French syndrome
  • White sponge nevus

Tabular List NotesGuidance

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

Inclusion Terms

  • Congenital malformation of mouth 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.

    • Aberrant(congenital)
      • sebaceous glands, mucous membrane, mouth, congenital
    • Absence(of) (organ or part) (complete or partial)
      • lip
    • Acheilia
    • Anomaly, anomalous(congenital) (unspecified type)
      • gum
    • Anomaly, anomalous(congenital) (unspecified type)
      • mouth
    • Aplasia
      • alveolar process (acquired)
        • congenital
    • Cyst(colloid) (mucous) (simple) (retention)
      • congenital NEC
        • sublingual
    • Cyst(colloid) (mucous) (simple) (retention)
      • congenital NEC
        • submaxillary gland
    • Deformity
      • mouth (acquired)
        • congenital
    • Disease, diseased
      • Fordyce's (ectopic sebaceous glands) (mouth)
    • Ectopic, ectopia(congenital)
      • sebaceous glands of mouth
    • Elongated, elongation(congenital)
      • uvula
    • Fordyce's disease(mouth)
    • Islands of
      • parotid tissue in
        • lymph nodes
    • Islands of
      • parotid tissue in
        • neck structures
    • Islands of
      • submaxillary glands in
        • fascia
    • Islands of
      • submaxillary glands in
        • lymph nodes
    • Islands of
      • submaxillary glands in
        • neck muscles
    • Malformation(congenital)
      • gum
    • Malformation(congenital)
      • mouth (congenital)
    • Nevus
      • mouth (mucosa)
        • white sponge
    • Nevus
      • oral mucosa
        • white sponge

Clinical ClassificationClinical

AHRQ’s CCSR groups this code into broader clinical categories.

CCSR MAL002
Digestive congenital anomalies
Default principal diagnosis: inpatient Yes · outpatient Yes

Patient EducationClinical

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.

The full article covers:

  • What are birth defects?
  • What causes birth defects?
  • Who is at risk of having a baby with birth defects?
  • How are birth defects diagnosed?
  • What are the treatments for birth defects?
  • Can birth defects be prevented?

Read the full article at MedlinePlus

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

Convert Q38.6 to ICD-9-CMHistory

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

ICD-9-CM
750.26 Mouth anomaly NEC
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 Q38.6Overview

Is Q38.6 (Other congenital malformations of tongue, mouth and pharynx) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report other congenital malformations of mouth on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

What MS-DRG does Q38.6 group to?

When other congenital malformations of mouth 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 Q38.6 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 other congenital malformations of mouth on inpatient claims.

What is the ICD-9 equivalent of Q38.6?

Under the General Equivalence Mappings, other congenital malformations of mouth converts to ICD-9-CM 750.26 (mouth anomaly NEC). 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.