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ICD-10-CM Code Q36.1
Cleft lip, median

BILLABLE
Billable Code
Billable codes are sufficient justification for admission to an acute care hospital when used a principal diagnosis.
POA Exempt
POA Exempt Code
The Center for Medicare & Medicaid Services (CMS) requires medical coders to indicate whether or not a condition was present at the time of admission, in order to properly assign MS-DRG codes. This "Present On Admission" (POA) indicator is recorded on CMS form 4010A.
| ICD-10 from 2011 - 2016

Q36.1 is a billable ICD code used to specify a diagnosis of cleft lip, median. A 'billable code' is detailed enough to be used to specify a medical diagnosis.

POA Indicators on CMS form 4010A are as follows:

IndicatorMeaningCMS Will Pay CC/MCC DRG Costs
YDiagnosis was present at time of inpatient admissionYes
NDiagnosis was not present at time of inpatient admissionNo
UDocumentation insufficient to determine if the condition was present at the time of inpatient admission.No
WClinically undetermined. Provider unable to clinically determine whether the condition was present at the time of inpatient admission.Yes
1Exempt from POA reportingNo


The ICD code Q36 is used to code Cleft lip and palate

Cleft lip and cleft palate, also known as orofacial cleft and cleft lip and palate, is a group of conditions that includes cleft lip (CL), cleft palate (CP), and both together (CLP). A cleft lip contains an opening in the upper lip that may extend into the nose. The opening may be on one side, both sides, or in the middle. A cleft palate is when the roof of the mouth contains an opening into the nose. These disorders can result in feeding problems, speech problems, hearing problems, and frequent ear infections. Less than half the time the condition is associated with other disorders.

Specialty: Otorhinolaryngology, Pediatrics
ICD 9 Code: 749

Child with cleft lip and palate.

Source: Wikipedia

MS-DRG Mapping

  • DRG Group #011-013 - Tracheostomy for face, mouth and neck diagnoses with MCC.
  • DRG Group #011-013 - Tracheostomy for face, mouth and neck diagnoses with CC.
  • DRG Group #011-013 - Tracheostomy for face, mouth and neck diagnoses without CC or MCC.
  • DRG Group #157-159 - Dental and oral diseases with MCC.
  • DRG Group #157-159 - Dental and oral diseases with CC.
  • DRG Group #157-159 - Dental and oral diseases without CC or MCC.

ICD-10-CM Alphabetical Index References for 'Q36.1 - Cleft lip, median'

The ICD-10-CM Alphabetical Index links the below-listed medical terms to the ICD code Q36.1. Click on any term below to browse the alphabetical index.

Equivalent ICD-9 Code GENERAL EQUIVALENCE MAPPINGS (GEM)

Cleft lip, unilateral, complete (approximate match)

This is the official approximate match mapping between ICD9 and ICD10, as provided by the General Equivalency mapping crosswalk. This means that while there is no exact mapping between this ICD10 code Q36.1 and a single ICD9 code, 749.11 is an approximate match for comparison and conversion purposes.


Parent Code: Q36 - Cleft lip

** This Document Provided By ICD.Codes **
Source: http://icd.codes/icd10cm/Q361