2022 ICD-10-CM Diagnosis Code Q38.0

Congenital malformations of lips, not elsewhere classified

    2016 2017 2018 2019 2020 2021 2022 Billable/Specific Code POA Exempt
  • Q38.0 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes.
  • The 2022 edition of ICD-10-CM Q38.0 became effective on October 1, 2021.
  • This is the American ICD-10-CM version of Q38.0 - other international versions of ICD-10 Q38.0 may differ.
Applicable To
  • Congenital fistula of lip
  • Congenital malformation of lip NOS
  • Van der Woude's syndrome
Type 1 Excludes
Type 1 Excludes Help
A type 1 excludes note is a pure excludes. It means "not coded here". A type 1 excludes note indicates that the code excluded should never be used at the same time as Q38.0. A type 1 excludes note is for used for when two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition.
  • cleft lip (
    ICD-10-CM Diagnosis Code Q36
    • Q36 Cleft lip
      • Q36.0 Cleft lip, bilateral
      • Q36.1 Cleft lip, median
      • Q36.9 Cleft lip, unilateral
    Q36.-
    )
  • cleft lip with cleft palate (
    ICD-10-CM Diagnosis Code Q37
    • Q37 Cleft palate with cleft lip
      • Q37.0 Cleft hard palate with bilateral cleft lip
      • Q37.1 Cleft hard palate with unilateral cleft lip
      • Q37.2 Cleft soft palate with bilateral cleft lip
      • Q37.3 Cleft soft palate with unilateral cleft lip
      • Q37.4 Cleft hard and soft palate with bilateral cle...
      • Q37.5 Cleft hard and soft palate with unilateral cl...
      • Q37.8 Unspecified cleft palate with bilateral cleft...
      • Q37.9 Unspecified cleft palate with unilateral clef...
    Q37.-
    )
  • macrocheilia (
    ICD-10-CM Diagnosis Code Q18.6

    Macrocheilia

      2016 2017 2018 2019 2020 2021 2022 Billable/Specific Code POA Exempt
    Applicable To
    • Hypertrophy of lip, congenital
    Q18.6
    )
  • microcheilia (
    ICD-10-CM Diagnosis Code Q18.7

    Microcheilia

      2016 2017 2018 2019 2020 2021 2022 Billable/Specific Code POA Exempt
    Q18.7
    )
The following code(s) above Q38.0 contain annotation back-references
Annotation Back-References
In this context, annotation back-references refer to codes that contain:
  • Applicable To annotations, or
  • Code Also annotations, or
  • Code First annotations, or
  • Excludes1 annotations, or
  • Excludes2 annotations, or
  • Includes annotations, or
  • Note annotations, or
  • Use Additional annotations
that may be applicable to Q38.0:
  • Q00-Q99
    2022 ICD-10-CM Range Q00-Q99

    Congenital malformations, deformations and chromosomal abnormalities

    Note
    • Codes from this chapter are not for use on maternal records
    Type 2 Excludes
    • inborn errors of metabolism (E70-E88)
    Congenital malformations, deformations and chromosomal abnormalities
  • Q38
    ICD-10-CM Diagnosis Code Q38

    Other congenital malformations of tongue, mouth and pharynx

      2016 2017 2018 2019 2020 2021 2022 Non-Billable/Non-Specific Code
    Type 1 Excludes
    Other congenital malformations of tongue, mouth and pharynx
Approximate Synonyms
  • Congenital fistula of lip
  • Fistula of lip, congenital
Clinical Information
  • A rare autosomal dominant syndrome caused by mutations in the irf6 gene. It is characterized by a cleft palate and/or pits on the lower lip. Other signs and symptoms include absent teeth, palate and tongue deformities.
Present On Admission
POA Help
"Present On Admission" is defined as present at the time the order for inpatient admission occurs — conditions that develop during an outpatient encounter, including emergency department, observation, or outpatient surgery, are considered POA.
  • Q38.0 is considered exempt from POA reporting.
ICD-10-CM Q38.0 is grouped within Diagnostic Related Group(s) (MS-DRG v39.0):
  • 011 Tracheostomy for face, mouth and neck diagnoses or laryngectomy with mcc
  • 012 Tracheostomy for face, mouth and neck diagnoses or laryngectomy with cc
  • 013 Tracheostomy for face, mouth and neck diagnoses or laryngectomy without cc/mcc
  • 157 Dental and oral diseases with mcc
  • 158 Dental and oral diseases with cc
  • 159 Dental and oral diseases without cc/mcc

Convert Q38.0 to ICD-9-CM

Code History
  • 2016 (effective 10/1/2015): New code (first year of non-draft ICD-10-CM)
  • 2017 (effective 10/1/2016): No change
  • 2018 (effective 10/1/2017): No change
  • 2019 (effective 10/1/2018): No change
  • 2020 (effective 10/1/2019): No change
  • 2021 (effective 10/1/2020): No change
  • 2022 (effective 10/1/2021): No change
Code annotations containing back-references to Q38.0:
  • Type 1 Excludes: K13.0
    ICD-10-CM Diagnosis Code K13.0

    Diseases of lips

      2016 2017 2018 2019 2020 2021 2022 Billable/Specific Code
    Applicable To
    • Abscess of lips
    • Angular cheilitis
    • Cellulitis of lips
    • Cheilitis NOS
    • Cheilodynia
    • Cheilosis
    • Exfoliative cheilitis
    • Fistula of lips
    • Glandular cheilitis
    • Hypertrophy of lips
    • Perlèche NEC
    Type 1 Excludes
    • ariboflavinosis (E53.0)
    • cheilitis due to radiation-related disorders (L55-L59)
    • congenital fistula of lips (Q38.0)
    • congenital hypertrophy of lips (Q18.6)
    • Perlèche due to candidiasis (B37.83)
    • Perlèche due to riboflavin deficiency (E53.0)

Diagnosis Index entries containing back-references to Q38.0:
  • Agenesis
    • lip Q38.0
  • Anomaly, anomalous (congenital) (unspecified type) Q89.9
    ICD-10-CM Diagnosis Code Q89.9

    Congenital malformation, unspecified

      2016 2017 2018 2019 2020 2021 2022 Billable/Specific Code POA Exempt
    Applicable To
    • Congenital anomaly NOS
    • Congenital deformity NOS
    • lip Q38.0
  • Deformity Q89.9
    ICD-10-CM Diagnosis Code Q89.9

    Congenital malformation, unspecified

      2016 2017 2018 2019 2020 2021 2022 Billable/Specific Code POA Exempt
    Applicable To
    • Congenital anomaly NOS
    • Congenital deformity NOS
    • lip (acquired) K13.0
      ICD-10-CM Diagnosis Code K13.0

      Diseases of lips

        2016 2017 2018 2019 2020 2021 2022 Billable/Specific Code
      Applicable To
      • Abscess of lips
      • Angular cheilitis
      • Cellulitis of lips
      • Cheilitis NOS
      • Cheilodynia
      • Cheilosis
      • Exfoliative cheilitis
      • Fistula of lips
      • Glandular cheilitis
      • Hypertrophy of lips
      • Perlèche NEC
      Type 1 Excludes
      • ariboflavinosis (E53.0)
      • cheilitis due to radiation-related disorders (L55-L59)
      • congenital fistula of lips (Q38.0)
      • congenital hypertrophy of lips (Q18.6)
      • Perlèche due to candidiasis (B37.83)
      • Perlèche due to riboflavin deficiency (E53.0)
      • congenital Q38.0
  • Ectropion H02.109
    ICD-10-CM Diagnosis Code H02.109

    Unspecified ectropion of unspecified eye, unspecified eyelid

      2016 2017 2018 2019 2020 2021 2022 Billable/Specific Code
    • lip (acquired) K13.0
      ICD-10-CM Diagnosis Code K13.0

      Diseases of lips

        2016 2017 2018 2019 2020 2021 2022 Billable/Specific Code
      Applicable To
      • Abscess of lips
      • Angular cheilitis
      • Cellulitis of lips
      • Cheilitis NOS
      • Cheilodynia
      • Cheilosis
      • Exfoliative cheilitis
      • Fistula of lips
      • Glandular cheilitis
      • Hypertrophy of lips
      • Perlèche NEC
      Type 1 Excludes
      • ariboflavinosis (E53.0)
      • cheilitis due to radiation-related disorders (L55-L59)
      • congenital fistula of lips (Q38.0)
      • congenital hypertrophy of lips (Q18.6)
      • Perlèche due to candidiasis (B37.83)
      • Perlèche due to riboflavin deficiency (E53.0)
      • congenital Q38.0
  • Fistula (cutaneous) L98.8
    ICD-10-CM Diagnosis Code L98.8

    Other specified disorders of the skin and subcutaneous tissue

      2016 2017 2018 2019 2020 2021 2022 Billable/Specific Code
    • lip K13.0
      ICD-10-CM Diagnosis Code K13.0

      Diseases of lips

        2016 2017 2018 2019 2020 2021 2022 Billable/Specific Code
      Applicable To
      • Abscess of lips
      • Angular cheilitis
      • Cellulitis of lips
      • Cheilitis NOS
      • Cheilodynia
      • Cheilosis
      • Exfoliative cheilitis
      • Fistula of lips
      • Glandular cheilitis
      • Hypertrophy of lips
      • Perlèche NEC
      Type 1 Excludes
      • ariboflavinosis (E53.0)
      • cheilitis due to radiation-related disorders (L55-L59)
      • congenital fistula of lips (Q38.0)
      • congenital hypertrophy of lips (Q18.6)
      • Perlèche due to candidiasis (B37.83)
      • Perlèche due to riboflavin deficiency (E53.0)
      • congenital Q38.0
  • Malformation (congenital) - see also Anomaly
    • lip Q38.0
  • Van der Woude's syndrome Q38.0

ICD-10-CM Codes Adjacent To Q38.0
Q37 Cleft palate with cleft lip
Q37.0 Cleft hard palate with bilateral cleft lip
Q37.1 Cleft hard palate with unilateral cleft lip
Q37.2 Cleft soft palate with bilateral cleft lip
Q37.3 Cleft soft palate with unilateral cleft lip
Q37.4 Cleft hard and soft palate with bilateral cleft lip
Q37.5 Cleft hard and soft palate with unilateral cleft lip
Q37.8 Unspecified cleft palate with bilateral cleft lip
Q37.9 Unspecified cleft palate with unilateral cleft lip
Q38 Other congenital malformations of tongue, mouth and pharynx
Q38.0 Congenital malformations of lips, not elsewhere classified
Q38.1 Ankyloglossia
Q38.2 Macroglossia
Q38.3 Other congenital malformations of tongue
Q38.4 Congenital malformations of salivary glands and ducts
Q38.5 Congenital malformations of palate, not elsewhere classified
Q38.6 Other congenital malformations of mouth
Q38.7 Congenital pharyngeal pouch
Q38.8 Other congenital malformations of pharynx
Q39 Congenital malformations of esophagus
Q39.0 Atresia of esophagus without fistula

Reimbursement claims with a date of service on or after October 1, 2015 require the use of ICD-10-CM codes.