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

ICD-10 Q38.4

Billable / Specific

Congenital malformations of salivary glands and ducts

Q38
Block
4
Synonyms
0
LCDs
2
Payer Policies
0
Linked CPTs

About ICD-10-CM Q38.4

ICD-10-CM code Q38.4 represents Congenital malformations of salivary glands and ducts. This is a billable/specific code in the Congenital Malformations chapter (block Q38). The 2026 edition of ICD-10-CM Q38.4 became effective on October 1, 2025.

Inclusion Terms / Approximate Synonyms

Clinical terms and conditions classified under Q38.4. Per CMS ICD-10-CM Tabular 2026.

  • Atresia of salivary glands and ducts
  • Congenital absence of salivary glands and ducts
  • Congenital accessory salivary glands and ducts
  • Congenital fistula of salivary gland

Medicare LCD Coverage for Q38.4

Local Coverage Determinations (LCDs) from CMS MACs that list Q38.4 as a covered diagnosis.

No Medicare LCDs reference Q38.4 as covered

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 Q38.4.

2 policies

1 Cigna

Head and Neck Ultrasound - (0549)
Policy ID: MM_0549

1 Aetna

Breast Pumps
Policy ID: CPB-0421

CPT Codes Commonly Billed with Q38.4

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

No procedure linkages on file for Q38.4

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 Q38.4 to ICD-9-CM

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

ICD-10ICD-9Mapping Flags
Q38.4 75021 10000
Q38.4 75022 10000
Q38.4 75023 10000
Q38.4 75024 10000

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

ICD-10 Q38.4, Billing FAQ

Is ICD-10 code Q38.4 billable? +

Yes, Q38.4 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 Q38.4? +

ICD-10 Q38.4 includes: Atresia of salivary glands and ducts; Congenital absence of salivary glands and ducts; Congenital accessory salivary glands and ducts, and 1 more clinical synonyms.

What ICD-9 codes does Q38.4 map to? +

Per CMS GEMs, Q38.4 maps to ICD-9 codes: 75021, 75022, 75023, 75024. 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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