ICD-10 Q36
Non-Billable HeaderCleft lip
About ICD-10-CM Q36
ICD-10-CM code Q36 represents Cleft lip. This is a non-billable header code in the Congenital Malformations chapter (block Q36). The 2026 edition of ICD-10-CM Q36 became effective on October 1, 2025. Non-billable codes cannot be used as a primary or secondary diagnosis on a claim, use a more specific child code instead.
Type 1 Excludes
Pure excludes, these codes can never be coded together with Q36. The conditions are mutually exclusive (e.g., congenital vs acquired forms).
- cleft lip with cleft palate (Q37.-)
Includes
- cheiloschisis
- congenital fissure of lip
- harelip
- labium leporinum
Medicare LCD Coverage for Q36
Local Coverage Determinations (LCDs) from CMS MACs that list Q36 as a covered diagnosis.
This doesn't mean the code isn't covered, it means no MAC has issued a Local Coverage Determination naming this specific code. Coverage may still apply under National Coverage Determinations or general medical-necessity rules.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing Q36.
Our payer policy database covers Aetna, Cigna, Anthem, BCBS, Humana, and Medicare Advantage plans, but Q36 doesn't currently appear in any indexed policy. The code may still be covered under standard plan benefits.
CPT Codes Commonly Billed with Q36
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
We don't have CPT pairings indexed for this specific code yet. Use the CPT search above to find common procedures, or check your payer's published medical policy for code-specific guidance.
Codes Adjacent To Q36
Other codes in section Q35-Q37 (Cleft lip and cleft palate).
ICD-10 Q36, Billing FAQ
Is ICD-10 code Q36 billable? +
No, Q36 is a non-billable header code. Use a more specific child code from block Q36 when submitting claims.
What codes are Type 1 Excludes for Q36? +
Type 1 Excludes (never code together with Q36): cleft lip with cleft palate (Q37.-)
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on June 1, 2026.
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