Q36.9
Q36.9: Cleft lip, unilateral
Billable / specific codeICD-10-CMPOA exempt
Q36.9 is a billable, specific ICD-10-CM code for cleft lip, unilateral. It is valid for submission on a claim.
Check Q36.9 with the rest of the claim: free scrubberInclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Cleft lip NOS
Other codes that can never be billed with Q36.9
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
Q36.9 is named in 7 Medicare coverage policies: 7 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›lip(unilateral)
Code history
Unchanged in every release from FY2024 to FY2027.