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

ICD-10 Q37.1

Billable / Specific

Cleft hard palate with unilateral cleft lip

Q37
Block
1
Synonyms
412
LCDs
7
Payer Policies
0
Linked CPTs

About ICD-10-CM Q37.1

ICD-10-CM code Q37.1 represents Cleft hard palate with unilateral cleft lip. This is a billable/specific code in the Congenital Malformations chapter (block Q37). The 2026 edition of ICD-10-CM Q37.1 became effective on October 1, 2025.

Inclusion Terms / Approximate Synonyms

Clinical terms and conditions classified under Q37.1. Per CMS ICD-10-CM Tabular 2026.

  • Cleft hard palate with cleft lip NOS

Medicare LCD Coverage for Q37.1

Local Coverage Determinations (LCDs) from CMS MACs that list Q37.1 as a covered diagnosis.

412 LCDs

Showing top 10 of 412 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 Q37.1.

7 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: MRI and CT Scans of the Head and Neck
Policy ID: ART-57204
Billing and Coding: Cosmetic and Reconstructive Surgery
Policy ID: ART-58573

CPT Codes Commonly Billed with Q37.1

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

No procedure linkages on file for Q37.1

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 Q37.1 to ICD-9-CM

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

ICD-10ICD-9Mapping Flags
Q37.1 74921 10000
Q37.1 74922 10000

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

ICD-10 Q37.1, Billing FAQ

Is ICD-10 code Q37.1 billable? +

Yes, Q37.1 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

What other names or terms map to Q37.1? +

ICD-10 Q37.1 includes: Cleft hard palate with cleft lip NOS.

What ICD-9 codes does Q37.1 map to? +

Per CMS GEMs, Q37.1 maps to ICD-9 codes: 74921, 74922. 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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