Q38.5

Q38.5: Congenital malformations of palate, not elsewhere classified

Billable / specific codeICD-10-CMPOA exempt

Q38.5 is a billable, specific ICD-10-CM code for congenital malformations of palate, not elsewhere classified. It is valid for submission on a claim.

Check Q38.5 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 palate (Q35.-)
cleft palate with cleft lip (Q37.-)

Inclusion terms

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

Congenital absence of uvula
Congenital malformation of palate NOS
Congenital high arched palate

Excludes1 inherited from the categories above Q38.5

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)

Risk adjustment

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

Alphabetic index entries that lead here

Absence›uvula, congenital
Agenesis›uvula
Anomaly, anomalous›palate NEC(hard) (soft)
Anomaly, anomalous›uvula
Deformity›palate(congenital)
Deformity›uvula(congenital)
Flaccid›palate, congenital
High›palate, congenital
Malformation›palate
Short, shortening, shortness›palate, congenital
Short, shortening, shortness›uvula, congenital
High›arch›palate, congenital

Code history

Unchanged in every release from FY2024 to FY2027.