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    OpenPayerBilling CodesCleft lip and cleft palateICD-10-CM q37-cleft-palate-with-cleft-lip
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    ICD-10-CM Code For Cleft Palate With Cleft Lip: Group Overview

    The International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) code group Q37 includes congenital anomalies combining cleft palate with cleft lip, specifying laterality and completeness of the clefts. These ICD-10-CM diagnosis codes are used to document congenital craniofacial defects that affect oral structure, feeding, speech, and dental development, capturing details such as unilateral or bilateral involvement and completeness. Accurate coding within the ICD-10-CM Q37 group supports proper claim adjudication, complete clinical documentation, and appropriate reimbursement.

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    ICD-10-CM Q37: Cleft Palate With Cleft Lip Overview

    The codes in this group represent congenital deformities involving both the lip and the palate, affecting oral and maxillofacial structures and functions such as feeding, speech, and dentition. These conditions are congenital anomalies of the craniofacial complex and often require multidisciplinary care. Accurate coding ensures clear clinical communication and supports appropriate reimbursement for surgical, rehabilitative, and supportive services.

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    When to Use

    Use a code from this group when a patient is diagnosed with both a cleft lip and a cleft palate and documentation specifies laterality or completeness. These codes are applied for initial birth records, outpatient evaluations, surgical planning, and ongoing care where the combined cleft condition is the focus of treatment or documentation.

    ICD-10-CM Codes

    8 rows

    ICD-10-CM CodeDescription
    Q37.0Cleft hard palate with bilateral cleft lip
    Q37.1Cleft hard palate with unilateral cleft lip
    Q37.2Cleft soft palate with bilateral cleft lip
    Q37.3Cleft soft palate with unilateral cleft lip
    Q37.4Cleft hard and soft palate with bilateral cleft lip
    Q37.5Cleft hard and soft palate with unilateral cleft lip
    Q37.8Unspecified cleft palate with bilateral cleft lip
    Q37.9Unspecified cleft palate with unilateral cleft lip

    DRG Codes

    6 rows

    DRG CodeDescription
    011Tracheostomy for Face, Mouth and Neck Diagnoses or Laryngectomy with MCC
    012Tracheostomy for Face, Mouth and Neck Diagnoses or Laryngectomy with CC
    013Tracheostomy for Face, Mouth and Neck Diagnoses or Laryngectomy without CC/MCC
    157Dental and Oral Diseases with MCC
    158Dental and Oral Diseases with CC
    159Dental and Oral Diseases without CC/MCC

    Typical Clinical Scenarios

    • An infant is evaluated in the newborn nursery after delivery with a visible split of the upper lip extending into the primary and secondary palate; feeding is difficult and the pediatric team consults plastic surgery for early planning of staged repair. A congenital combined cleft of lip and palate is documented after physical exam and possibly imaging, and a specific code reflecting the laterality and extent of the cleft is assigned. Typical codes: Q37.0, Q37.1
    • A 6-month-old presents to the multidisciplinary cleft clinic for ongoing management after initial lip repair; concerns include persistent palatal insufficiency with nasal regurgitation and speech delays, prompting evaluation by ENT and speech therapy for surgical and therapeutic planning. The visit codes the congenital cleft involving both lip and palate as the underlying diagnosis driving follow-up care and coordination. Typical codes: Q37.2, Q37.3
    • A school-age child with a previously repaired unilateral cleft lip and palate is seen urgently for recurrent otitis media and conductive hearing loss related to Eustachian tube dysfunction; tympanostomy tube placement is planned, and the encounter documents the congenital cleft lip with cleft palate as a comorbid condition affecting ENT management. Typical codes: Q37.4, Q37.5, Q37.9

    Related Codes

    Q35-CLEFT-PALATE

    ICD-10-CM Code For Cleft Palate: Group Overview

    Q36-CLEFT-LIP

    ICD-10-CM Code For Cleft Lip: Group Overview

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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