Skip to main content

Q37.3 ICD-10-CM Code: Cleft soft palate with unilateral cleft lip

Compare with another codeCheck this code on a claim

Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.

Coding at a Glance

Tabular directives
2 inclusion terms · 1 Excludes2 · 1 use-additional code

Billable · FY2027A valid, specific ICD-10-CM code, reportable for dates of service in FY2027.

What you need to know

Source: CMS/NCHS Official ICD-10-CM tabular notes, quoted. From the CMS/NCHS tabular list for the release in force. A note the category or block publishes applies to this code too; the Instructions section marks which is which.

Use additional codeReport with this code when documented
  • code to identify associated malformation of the nose (Q30.2)
Excludes2Not included here; may be reported together
IncludesWhat this code covers
  • cheilopalatoschisis
  • Cleft soft palate with cleft lip NOS

Most relevant related codes MedCoder-derived

Read off the official notes above and this code’s own position in the tabular list. Which to report is a documentation question; Compare shows the two side by side.

CompareCheck ClaimView Related Codes

Inpatient Payment Groups (MS-DRG)

Potential MS-DRG participation — not a DRG assignment.

MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v44, Appendix B.

  • MS-DRG 011 — TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH MCC (MDC PRE)
  • MS-DRG 012 — TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH CC (MDC PRE)
  • MS-DRG 013 — TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITHOUT CC/MCC (MDC PRE)
  • MS-DRG 157 — DENTAL AND ORAL DISEASES WITH MCC (MDC 03)
  • MS-DRG 158 — DENTAL AND ORAL DISEASES WITH CC (MDC 03)
  • MS-DRG 159 — DENTAL AND ORAL DISEASES WITHOUT CC/MCC (MDC 03)

A diagnosis appearing in a group's logic does not by itself determine the DRG assigned to a stay; the grouper uses the full claim.

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for Q37.3 in the official ICD-10-CM tabular list, quoted as published.

Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2027Effective: October 1, 2026

Trace:FY2027 changesChange historyRelease, file and checksum

Notes without a marker are published on Q37.3 itself; “inherited from” names the category or block whose note applies here.

Includes

Conditions the official ICD-10-CM tabular list includes under this code.

  • cheilopalatoschisis

Source: inherited from Q37

Inclusion Terms

Alternative terms the tabular list files under this code.

  • Cleft soft palate with cleft lip NOS

Excludes2 — Not Included Here

Conditions not covered by this code, but which may be reported alongside it when both are present.

Source: inherited from Q35-Q37

Use Additional Code

Supplementary codes the tabular list directs you to add.

  • Use additional code to identify associated malformation of the nose (Q30.2)

Source: inherited from Q35-Q37

Coder workflow for Q37.3

MedCoder structured workflow — derived from this code’s own official record

Before you code Q37.3

  1. Q37.3’s title joins a condition with an associated condition or complication. Confirm each component is documented. Where the classification presumes the link through the “with” convention, only a provider statement that the conditions are unrelated defeats it. A combination code is assigned only when it fully identifies the documented conditions; a required second code for the stage, type or manifestation is still reported when the notes ask for it (Guidelines I.B.9, I.A.15).

    Guide: Combination codes →

Documentation check

The provider’s diagnostic statement
Codes are assigned from the provider’s documented diagnosis, not from clinical criteria, test values or a medication list (Guidelines I.A.19).
The associated condition or complication
Whether the associated condition the title names is documented; the “with” convention presumes some links, and a provider statement that the conditions are unrelated defeats it (Guidelines I.A.15).
The conditions the Use Additional Code note names
Reported with this code when documented; a conditional instruction (“if applicable”, “if known”) applies only when the record supports it.

Official instructions as workflow

  • Excludes2 — not part of Q37.3(1 note)

    Coding workflow: The conditions named in this note are not included in Q37.3. When the record documents both, both may be reported; the note is a boundary, not a prohibition.

    CompareQ87.0

    See the official tabular notes · Guidelines I.A.12.b

  • Use Additional Code — after identifying Q37.3(1 note)

    Coding workflow: Check whether the documentation supports the additional code(s) the note names, and report them with Q37.3 when it does. Where the instruction is conditional (“if applicable”, “if known”), it applies only when the record documents the condition.

    ReviewQ30.2

    See the official tabular notes · Guidelines I.A.13

Coding decision scenarios

Pattern scenarios for this code’s structure — decision rules, not clinical cases

Documentation: Only one of the components this code’s title joins is documented.

Coding question: Is Q37.3 supported?

Path: Review the code for the documented component on its own.

Reason: A combination code is assigned only when it fully identifies the documented conditions; otherwise the documented component takes its own code (Guidelines I.B.9).

Documentation: A condition the Use Additional Code note names is documented.

Coding question: Is a second code reported with Q37.3?

Path: Review the Use Additional Code note and the code it names.

Reason: The additional code is reported when the record documents the condition; a conditional instruction applies only when its condition is met (Guidelines I.A.13).

ReviewQ30.2

Every row is derived from this code’s own record — its title, tabular notes, 7th-character family and same-category siblings — with fixed MedCoder wording; nothing is inferred about a patient. The official notes and guideline text are in the sections each row links to, and they control.

Don’t confuse Q37.3 with…

MedCoder analysis — pairs from this code’s official notes, distinctions written by MedCoder

The codes most likely to be picked instead of Q37.3 — named in its own official notes, or sharing its laterality or encounter family — with what separates them and which documentation moves the case. Each links to the full comparison.

  • Q37.8— Specificity relationship (Review)

    Overlapping diagnoses in the same category.

    Overlapping codes in the same category — the documentation decides which is the more specific fit.

    What moves you there: A record that documents no more than “Unspecified cleft palate with bilateral cleft lip” takes Q37.8; specificity in the record moves it back here.

    Full comparison: Q37.3 vs Q37.8 →

  • Q87.0— Excludes2 relationship (Informational)

    Distinct conditions — both may be reported.

    A distinct condition — both may be reported when both are documented.

    What moves you there: Documentation of Robin's syndrome adds Q87.0; it is not part of this code and both may be reported when both are documented.

    Full comparison: Q37.3 vs Q87.0 →

Relationships are read from this code's own official notes, its laterality siblings and its encounter family; the wording of each distinction is MedCoder editorial, and the documentation named in each “what moves you there” line is the official note phrase or sibling title itself. Source: CMS ICD-10-CM tabular instructional notes; ICD-10-CM Official Guidelines, Section I.A.12.a.

Coding context

Guidelines, coding notes, decision aids, relationships (with MS-DRG and CCSR classification), hierarchy, HCC, coverage and the context map: what a coder reaches for after the core. Each section names whether it is official source data, a MedCoder-derived relationship or MedCoder editorial.

Code Overview

Cleft soft palate with unilateral cleft lip is a billable ICD-10-CM diagnosis code (Q37.3).

MedCoder summary Summary composed by MedCoder from this code's official ICD-10-CM record. The tabular instructional notes themselves appear verbatim below.

Verify Before Coding

  • No Medicare Code Editor or MS-DRG Definitions Manual restrictions apply to this code.

From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim in Claim Check.

Relationships & Classification

MedCoder-derived relationships — computed from published CMS and AHRQ datasets

Other codes that name Q37.3 or its code family, from the CMS ICD-10-CM tabular instructional notes. Tabular-note edges are stored at the code family level that carries each note.

Referenced by 5 Excludes1 notes: Q18 — Other congenital malformations of face and neck (via Q37.-), Q35 — Cleft palate (via Q37.-), Q36 — Cleft lip (via Q37.-), Q38.0 — Congenital malformations of lips, not elsewhere classified (via Q37.-), Q38.5 — Congenital malformations of palate, not elsewhere classified (via Q37.-).

These codes’ tabular lists mark this diagnosis as mutually exclusive — not reported together unless the conditions are documented as unrelated.

Referenced by 9 Excludes2 notes: Q10 — Congenital malformations of eyelid, lacrimal apparatus and orbit (via Q37.-), Q10-Q18 — Congenital malformations of eye, ear, face and neck (Q10-Q18) (via Q37.-), Q11 — Anophthalmos, microphthalmos and macrophthalmos (via Q37.-), Q12 — Congenital lens malformations (via Q37.-), Q13 — Congenital malformations of anterior segment of eye (via Q37.-), Q14 — Congenital malformations of posterior segment of eye (via Q37.-), Q15 — Other congenital malformations of eye (via Q37.-), Q16 — Congenital malformations of ear causing impairment of hearing (via Q37.-), Q17 — Other congenital malformations of ear (via Q37.-).

These codes’ tabular lists name this diagnosis as distinct — both may be reported when both are documented.

MS-DRG Grouper Relationships (FY2027)

Potential MS-DRG participation — not a DRG assignment.

FY2027 MS-DRG: not on the CMS CC/MCC list — as a secondary diagnosis this code does not change MS-DRG severity for that release.

Named in the grouper logic of 6 MS-DRGs: DRG 011 (MDC PRE), DRG 012 (MDC PRE), DRG 013 (MDC PRE), DRG 157 (MDC 03), DRG 158 (MDC 03), DRG 159 (MDC 03).

From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.

Clinical classification (AHRQ CCSR):MAL006 — Cleft lip or palate (default).

Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.

Related Codes

Same clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical category (Cleft lip or palate).

Q35.1 — Cleft hard palate, Q35.3 — Cleft soft palate, Q35.5 — Cleft hard palate with cleft soft palate, Q35.7 — Cleft uvula, Q35.9 — Cleft palate, unspecified, Q36.0 — Cleft lip, bilateral, Q36.1 — Cleft lip, median, Q36.9 — Cleft lip, unilateral, Q37.0 — Cleft hard palate with bilateral cleft lip, Q37.1 — Cleft hard palate with unilateral cleft lip, Q37.2 — Cleft soft palate with bilateral cleft lip, Q37.4 — Cleft hard and soft palate with bilateral cleft lip, Q37.5 — Cleft hard and soft palate with unilateral cleft lip, Q37.8 — Unspecified cleft palate with bilateral cleft lip, Q37.9 — Unspecified cleft palate with unilateral cleft lip

Same Index main term, other category

The ICD-10-CM Index to Diseases and Injuries files this code under the main term “Cleft”; these codes share that main term but sit in a different category of the Tabular List.

M26.79 — Other specified alveolar anomalies (alveolar process), Q18.0 — Sinus, fistula and cyst of branchial cleft (branchial, cyst), Q18.2 — Other branchial cleft malformations (branchial), Q23.82 — Congenital mitral valve cleft leaflet (mitral valve leaflet), Q30.2 — Fissured, notched and cleft nose (nose), Q31.8 — Other congenital malformations of larynx (thyroid cartilage), Q35.1 — Cleft hard palate (palate, hard), Q35.3 — Cleft soft palate (palate, soft), Q35.5 — Cleft hard palate with cleft soft palate (palate, medial), Q35.7 — Cleft uvula (uvula), Q35.9 — Cleft palate, unspecified (palate), Q36.0 — Cleft lip, bilateral (lip, bilateral), Q36.1 — Cleft lip, median (lip, median), Q36.9 — Cleft lip, unilateral (lip), Q55.29 — Other congenital malformations of testis and scrotum (scrotum), Q55.69 — Other congenital malformation of penis (penis), Q71.6 — Lobster-claw hand (hand), Q72.7 — Split foot (foot)

Contextual Map

Every relationship of Q37.3 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.

Run Q37.3 with these 13 related codes in Claim Check

Hierarchy

Referenced by Excludes1 notes

Referenced by Excludes2 notes (9)

Clinical classification (CCSR)

MS-DRG Grouper

MDC crossing

  • Pre-MDC[MDC crossing]: “Pre-MDC — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs. 175 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2027
  • MDC 03 — Diseases and Disorders of the Ear, Nose, Mouth and Throat[MDC crossing]: “Diseases and Disorders of the Ear, Nose, Mouth and Throat — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs. 5,151 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2027

Index entries

  • Cleft (congenital), lip (unilateral), with cleft palate, soft[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
  • Cleft (congenital), palate, soft, with, cleft lip (unilateral)[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027

Nearest codes

Change history

  • FY2016 — In the code set at ICD-10-CM adoption [Change history]— CMS release files (code change ledger) · icd10cm-fy2016

Reference

Index terms and tables, published questions and FAQ, every source behind this page with its release and checksum, the date-of-service check and the complete change history.

Indexed Clinical Terms (2)

Official source data — entries quoted as published, in the Index’s own lookup phrasing

Clinical term phrases from the official ICD-10-CM Index to Diseases and Injuries that map to this code. These are alphabetic-index entries shown as the Index writes them — lookup phrasing, not necessarily the wording of a final diagnosis.

Sources for this page

Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.

Code, title, tabular notes and index terms Official source data
CMS/CDC ICD-10-CM FY2027 tabular list, index and tables, effective October 1, 2026 Release, file and checksum · Publisher’s page
Claim edits Official source data
CMS Definitions of Medicare Code Edits — v44.0 (October 2026) Release, file and checksum · Publisher’s page
Inpatient payment groups Official source data
CMS MS-DRG Definitions Manual (incl. Appendix B diagnosis index, Appendix C CC/MCC list, Appendix E procedure index) and IPPS Final Rule tables — v44 Release, file and checksum · Publisher’s page
Change history and date-of-service validity Official source data
CMS ICD-10-CM release addenda, ingested release by release into the change ledger Release, file and checksum · Publisher’s page
Comparisons, relationships and the contextual map MedCoder-derived relationship
Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears
Summary and FAQ answers MedCoder editorial explanation
Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.

Current data releases:ICD-10-CM FY2027 · ICD-10-PCS FY2027 · HCPCS October 2026 · MS-DRG v44 · Medicare Code Editor v44.0 · NCCI PTP Q4 2026 · MUE Q4 2026 · NCD code lists 2026-01 · LCD export September 20, 2026 · All releases and sources

Labels on this page: Official source data · MedCoder-derived relationship · MedCoder editorial explanation. How to read the labels · All data sources and release dates · CMS coding rules

Cite this page

Reference this page in a research guide, syllabus or article. The release is included because code content changes each year.

MedCoder.ai. "Q37.3 — Cleft soft palate with unilateral cleft lip." ICD-10-CM FY2027. https://medcoder.ai/icd10/code/q37.3-cleft-soft-palate-with-unilateral-cleft-lip

Change history

  • FY2016 — October 1, 2015
    In the code set at ICD-10-CM adoption
    Cleft soft palate with unilateral cleft lip

No changes since FY2016 — additions, deletions, description changes and billable-status changes are tracked through FY2027, and none are recorded for this code. Note changes are tracked from FY2027 only.

Nearest Codes in This Family

Official ICD-10-CM classifications closest to Q37.3 in its code family, with their registry titles.

View all codes in the Q37 family