ICD-10-CM 2026 · Effective October 1, 2025

ICD-10 Q36.0

Billable / Specific

Cleft lip, bilateral

Q36
Block
0
Synonyms
384
LCDs
6
Payer Policies
0
Linked CPTs

About ICD-10-CM Q36.0

ICD-10-CM code Q36.0 represents Cleft lip, bilateral. This is a billable/specific code in the Congenital Malformations chapter (block Q36). The 2026 edition of ICD-10-CM Q36.0 became effective on October 1, 2025.

Medicare LCD Coverage for Q36.0

Local Coverage Determinations (LCDs) from CMS MACs that list Q36.0 as a covered diagnosis.

384 LCDs

Showing top 10 of 384 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Cosmetic and Reconstructive Surgery
Article ID: 58573, Effective: 2025-11-17 00:00:00, 137 covered, 1 non-covered
CPT 19300 →
CMS LCD: Billing and Coding: Cosmetic and Reconstructive Surgery
Article ID: 58573, Effective: 2025-11-17 00:00:00, 137 covered, 1 non-covered
CPT 15877 →
CMS LCD: Billing and Coding: Cosmetic and Reconstructive Surgery
Article ID: 58573, Effective: 2025-11-17 00:00:00, 137 covered, 1 non-covered
CPT 19371 →
CMS LCD: Billing and Coding: Cosmetic and Reconstructive Surgery
Article ID: 58573, Effective: 2025-11-17 00:00:00, 137 covered, 1 non-covered
CPT 19380 →
CMS LCD: Billing and Coding: Cosmetic and Reconstructive Surgery
Article ID: 58573, Effective: 2025-11-17 00:00:00, 137 covered, 1 non-covered
CPT 30468 →
CMS LCD: Billing and Coding: Cosmetic and Reconstructive Surgery
Article ID: 58573, Effective: 2025-11-17 00:00:00, 137 covered, 1 non-covered
CPT 30400 →
CMS LCD: Billing and Coding: Cosmetic and Reconstructive Surgery
Article ID: 58573, Effective: 2025-11-17 00:00:00, 137 covered, 1 non-covered
CPT 19396 →
CMS LCD: Billing and Coding: Cosmetic and Reconstructive Surgery
Article ID: 58573, Effective: 2025-11-17 00:00:00, 137 covered, 1 non-covered
CPT 30435 →
CMS LCD: Billing and Coding: Cosmetic and Reconstructive Surgery
Article ID: 58573, Effective: 2025-11-17 00:00:00, 137 covered, 1 non-covered
CPT 30465 →
CMS LCD: Billing and Coding: Cosmetic and Reconstructive Surgery
Article ID: 58573, Effective: 2025-11-17 00:00:00, 137 covered, 1 non-covered
CPT 30462 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing Q36.0.

6 policies

5 Medicare

Billing and Coding: Cosmetic and Reconstructive Surgery
Policy ID: ART-56587
Billing and Coding: Cosmetic and Reconstructive Surgery
Policy ID: ART-56658
Billing and Coding: Outpatient Speech Language Pathology
Policy ID: ART-56868
Billing and Coding: Cosmetic and Reconstructive Surgery
Policy ID: ART-58573
Billing and Coding: Cosmetic and Reconstructive Surgery
Policy ID: ART-58774

CPT Codes Commonly Billed with Q36.0

Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.

No procedure linkages on file for Q36.0

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.

Convert Q36.0 to ICD-9-CM

Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.

ICD-10ICD-9Mapping Flags
Q36.0 74913 10000
Q36.0 74914 10000

Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).

ICD-10 Q36.0, Billing FAQ

Is ICD-10 code Q36.0 billable? +

Yes, Q36.0 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

What ICD-9 codes does Q36.0 map to? +

Per CMS GEMs, Q36.0 maps to ICD-9 codes: 74913, 74914. Useful for legacy data review and historical claim analysis.

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Reviewed by the PayerReady Medical Coding Team

Verified against the CMS 2026 code set on May 31, 2026.

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