Q38.0

Q38.0: Congenital malformations of lips, not elsewhere classified

Billable / specific codeICD-10-CMPOA exempt

Q38.0 is a billable, specific ICD-10-CM code for congenital malformations of lips, not elsewhere classified. It is valid for submission on a claim.

Check Q38.0 with the rest of the claim: free scrubber

Excludes1: never code together

These conditions cannot occur together. Billing both on the same encounter is a denial.

cleft lip (Q36.-)
cleft lip with cleft palate (Q37.-)
macrocheilia (Q18.6)
microcheilia (Q18.7)

Inclusion terms

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

Congenital fistula of lip
Congenital malformation of lip NOS
Van der Woude's syndrome

Excludes1 inherited from the categories above Q38.0

A category’s note binds every code beneath it.

Written on Q38: Other congenital malformations of tongue, mouth and pharynx

dentofacial anomalies (M26.-)
macrostomia (Q18.4)
microstomia (Q18.5)

Other codes that can never be billed with Q38.0

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

K13.0Diseases of lips

Risk adjustment

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

Alphabetic index entries that lead here

Van der Woude's syndrome
Agenesis›lip
Anomaly, anomalous›lip
Malformation›lip
Deformity›lip NEC›congenital
Ectropion›lip›congenital
Fistula›lip›congenital

Code history

Unchanged in every release from FY2024 to FY2027.