Is Q37.5 a billable ICD-10-CM code?

Yes. Q37.5 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does Q37.5 sit in the tabular list?

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

Q37.5

Q37.5 — Cleft hard and soft palate with unilateral cleft lip

Billable / specific codeICD-10-CMPOA exempt

Q37.5 is a billable, specific ICD-10-CM code for cleft hard and soft palate with unilateral cleft lip. It is valid for submission on a claim.

Inclusion terms

Alternative wordings a physician may use in the chart for this same code.

Cleft hard and soft palate with cleft lip NOS

Risk adjustment

Q37.5 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

Q37.5 is named in 7 Medicare coverage policies — 7 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
A57204Billing and Coding: MRI and CT Scans of the Head and Neck

How Q37.5 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 Q37.5.

Cleft›lip›with cleft palate›hard›with soft
Cleft›lip›with cleft palate›soft›with hard
Cleft›palate›hard›with›soft›with cleft lip(unilateral)
Cleft›palate›soft›with›hard›with cleft lip(unilateral)

Related codes at this level

Codes that share Q37. If Q37.5 is not quite right, the correct code is usually one of these.

Questions about Q37.5

Is Q37.5 a billable ICD-10-CM code?: Yes. Q37.5 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does Q37.5 sit in the tabular list?: Congenital malformations, deformations and chromosomal abnormalities (Q00-QA0), in the block Cleft lip and cleft palate (Q35-Q37).