Q36.0 — Cleft lip, bilateral
Q36.0 is a billable, specific ICD-10-CM code for cleft lip, bilateral. It is valid for submission on a claim.
Risk adjustment
Q36.0 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
Q36.0 is named in 6 Medicare coverage policies — 6 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- 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
How Q36.0 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 Q36.0.
- Cleft›lip›bilateral
Related codes at this level
Codes that share Q36. If Q36.0 is not quite right, the correct code is usually one of these.
Questions about Q36.0
- Is Q36.0 a billable ICD-10-CM code?
- Yes. Q36.0 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does Q36.0 sit in the tabular list?
- Congenital malformations, deformations and chromosomal abnormalities (Q00-QA0), in the block Cleft lip and cleft palate (Q35-Q37).