Q35.5

Q35.5: Cleft hard palate with cleft soft palate

Billable / specific codeICD-10-CMPOA exempt

Q35.5 is a billable, specific ICD-10-CM code for cleft hard palate with cleft soft palate. It is valid for submission on a claim.

Check Q35.5 with the rest of the claim: free scrubber

Excludes1 inherited from the categories above Q35.5

A category’s note binds every code beneath it.

Written on Q35: Cleft palate

cleft palate with cleft lip (Q37.-)

Other codes that can never be billed with Q35.5

Their own Excludes1 notes name this code, so the conflict is not listed above.

Q38.5Congenital malformations of palate, not elsewhere classified

Risk adjustment

No CMS-HCC V28 category: this code does not change a RAF score.

Medicare coverage

Q35.5 is named in 8 Medicare coverage policies: 8 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

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

Alphabetic index entries that lead here

Cleft›palate›medial
Cleft›palate›hard›with›soft
Cleft›palate›soft›with›hard

Code history

Unchanged in every release from FY2024 to FY2027.