Q36.0

Q36.0: Cleft lip, bilateral

Billable / specific codeICD-10-CMPOA exemptbilateral

Q36.0 is a billable, specific ICD-10-CM code for cleft lip, bilateral. It is valid for submission on a claim.

Check Q36.0 with the rest of the claim: free scrubber

Excludes1 inherited from the categories above Q36.0

A category’s note binds every code beneath it.

Written on Q36: Cleft lip

cleft lip with cleft palate (Q37.-)

Other codes that can never be billed with Q36.0

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

Q38.0Congenital malformations of lips, not elsewhere classified

Risk adjustment

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

Medicare coverage

Q36.0 is named in 6 Medicare coverage policies: 6 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

A56587Billing and Coding: Cosmetic and Reconstructive Surgery
A56658Billing and Coding: Cosmetic and Reconstructive Surgery
A56868Billing and Coding: Outpatient Speech Language Pathology
A58573Billing and Coding: Cosmetic and Reconstructive Surgery

Alphabetic index entries that lead here

Cleft›lip›bilateral

Code history

Unchanged in every release from FY2024 to FY2027.