ICD-10-CM Code Q38.0
Congenital malformations of lips, not elsewhere classified
Billable Code
Billable codes are sufficient justification for admission to an acute care hospital when used a principal diagnosis.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.Q38.0 is a billable ICD code used to specify a diagnosis of congenital malformations of lips, not elsewhere classified. A 'billable code' is detailed enough to be used to specify a medical diagnosis.
POA Indicators on CMS form 4010A are as follows:
| Indicator | Meaning | CMS Will Pay CC/MCC DRG Costs |
|---|---|---|
| Y | Diagnosis was present at time of inpatient admission | Yes |
| N | Diagnosis was not present at time of inpatient admission | No |
| U | Documentation insufficient to determine if the condition was present at the time of inpatient admission. | No |
| W | Clinically undetermined. Provider unable to clinically determine whether the condition was present at the time of inpatient admission. | Yes |
| 1 | Exempt from POA reporting | No |
The ICD code Q380 is used to code Van der Woude syndrome
Van der Woude syndrome (VDWS) is a genetic disorder characterized by the combination of lower lip pits, cleft lip with or without cleft palate, and cleft palate alone (CP). The frequency of orofacial clefts ranges from 1:1000 to 1:500 births worldwide, and there are more than 400 syndromes that involve cleft lip with or without cleft palate. VWS is distinct from other clefting syndromes due to the combination of cleft lip and palate (CLP) and CP within the same family. Other features frequently associated with VWS include hypodontia in 10-81% of cases, narrow arched palate, congenital heart disease, heart murmur and cerebral abnormalities, syndactyly of the hands, polythelia, ankyloglossia, and adhesions between the upper and lower gum pads.
| Specialty: | Medical Genetics |
Coding Notes for Q38.0 Info for medical coders on how to properly use this ICD-10 code
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Inclusion Terms:
Inclusion Terms
Inclusion Terms are a list of concepts for which a specific code is used. The list of Inclusion Terms is useful for determining the correct code in some cases, but the list is not necessarily exhaustive. - Congenital fistula of lip
- Congenital malformation of lip NOS
- Van der Woude's syndrome
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Code Type-1 Excludes:
Type-1 Excludes
Type-1 Excludes mean the conditions excluded are mutually exclusive and should never be coded together. Excludes 1 means "do not code here." - Cleft lip - instead, use code Q36.-
- Cleft lip with cleft palate - instead, use code Q37.-
- Macrocheilia - instead, use code Q18.6
- Microcheilia - instead, use code Q18.7
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 'Q38.0 - Congenital malformations of lips, not elsewhere classified'
The ICD-10-CM Alphabetical Index links the below-listed medical terms to the ICD code Q38.0. Click on any term below to browse the alphabetical index.
Equivalent ICD-9 Code GENERAL EQUIVALENCE MAPPINGS (GEM)
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 Q38.0 and a single ICD9 code, 750.25 is an approximate match for comparison and conversion purposes.
Parent Code: Q38 - Other congenital malformations of tongue, mouth and pharynx