Is Q35.1 a billable ICD-10-CM code?

Yes. Q35.1 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does Q35.1 sit in the tabular list?

Congenital malformations, deformations and chromosomal abnormalities (Q00-QA0), in the block Cleft lip and cleft palate (Q35-Q37).

What cannot be coded together with Q35.1?

Q35.1 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above Q35.1 (Q35) and apply to it just the same.

Q35.1

Q35.1 — Cleft hard palate

Billable / specific codeICD-10-CMPOA exempt

Q35.1 is a billable, specific ICD-10-CM code for cleft hard palate. It is valid for submission on a claim.

Excludes1 inherited from the categories above Q35.1

These are not written on Q35.1, but they bind it: a note on a category applies to every code beneath it. Billing Q35.1 with anything listed here is a denial.

Written on Q35 — Cleft palate

cleft palate with cleft lip (Q37.-)

Other codes that can never be billed with Q35.1

These codes carry an Excludes1 note pointing at Q35.1. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading Q35.1 alone.

Q38.5Congenital malformations of palate, not elsewhere classified

Risk adjustment

Q35.1 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.

Medicare coverage

Q35.1 is named in 8 Medicare coverage policies — 8 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

A54111Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders
A56587Billing and Coding: Cosmetic and Reconstructive Surgery
A56658Billing and Coding: Cosmetic and Reconstructive Surgery
A56868Billing and Coding: Outpatient Speech Language Pathology

How Q35.1 is indexed

Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to Q35.1.

Perforation, perforated›palatine vault
Cleft›palate›hard

Code history

Q35.1 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.

Related codes at this level

Codes that share Q35. If Q35.1 is not quite right, the correct code is usually one of these.

Questions about Q35.1

Is Q35.1 a billable ICD-10-CM code?: Yes. Q35.1 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does Q35.1 sit in the tabular list?: Congenital malformations, deformations and chromosomal abnormalities (Q00-QA0), in the block Cleft lip and cleft palate (Q35-Q37).
What cannot be coded together with Q35.1?: Q35.1 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above Q35.1 (Q35) and apply to it just the same.