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Q37 vs Q38.0

Q37 (Cleft palate with cleft lip) compared with Q38.0 (Congenital malformations of lips, not elsewhere classified), from the official CMS tabular data. Do not report these codes together: the official tabular list marks them Excludes1.

Can these codes be reported together?

No — do not report together. Q38.0 carries an Excludes1 note covering Q37: “cleft lip with cleft palate (Q37.-)”

Sole exception: when the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

Side by side

Q37Cleft palate with cleft lipQ38.0Congenital malformations of lips, not elsewhere classified
Billing statusNon-billable header

Report instead: Q37.0, Q37.1, Q37.2, Q37.3, Q37.4

Billable
ClassificationQ00-Q99 — Congenital Malformations, Deformations and Chromosomal Abnormalities (Q00-Q99)Q00-Q99 — Congenital Malformations, Deformations and Chromosomal Abnormalities (Q00-Q99)
DefinitionCleft palate with cleft lip is a non-billable ICD-10-CM category code (Q37).Congenital malformations of lips, not elsewhere classified is a billable ICD-10-CM diagnosis code (Q38.0).
Includes
cheilopalatoschisis
Congenital fistula of lip
Congenital malformation of lip NOS
Van der Woude's syndrome
Use additional code
code to identify associated malformation of the nose (Q30.2)

Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources