2021 ICD-10-CM Diagnosis Code Q38.5

Congenital malformations of palate, not elsewhere classified

    2016 2017 2018 2019 2020 2021 Billable/Specific Code POA Exempt
  • Q38.5 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes.
  • The 2021 edition of ICD-10-CM Q38.5 became effective on October 1, 2020.
  • This is the American ICD-10-CM version of Q38.5 - other international versions of ICD-10 Q38.5 may differ.
Applicable To
  • Congenital absence of uvula
  • Congenital malformation of palate NOS
  • Congenital high arched palate
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 Q38.5. 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 palate (
    ICD-10-CM Diagnosis Code Q35
    • Q35 Cleft palate
      • Q35.1 Cleft hard palate
      • Q35.3 Cleft soft palate
      • Q35.5 Cleft hard palate with cleft soft palate
      • Q35.7 Cleft uvula
      • Q35.9 Cleft palate, unspecified
    Q35.-
    )
  • cleft palate with cleft lip (
    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.-
    )
The following code(s) above Q38.5 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 Q38.5:
  • Q00-Q99
    2021 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 Non-Billable/Non-Specific Code
    Type 1 Excludes
    Other congenital malformations of tongue, mouth and pharynx
Approximate Synonyms
  • Congenital absence of uvula
  • Congenital anomaly of palate
  • Congenital palate anomaly
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.
  • Q38.5 is considered exempt from POA reporting.
ICD-10-CM Q38.5 is grouped within Diagnostic Related Group(s) (MS-DRG v38.0):
  • 393 Other digestive system diagnoses with mcc
  • 394 Other digestive system diagnoses with cc
  • 395 Other digestive system diagnoses without cc/mcc

Convert Q38.5 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

Diagnosis Index entries containing back-references to Q38.5:
  • Absence (of) (organ or part) (complete or partial)
    • uvula, congenital Q38.5
  • Agenesis
    • uvula Q38.5
  • Anomaly, anomalous (congenital) (unspecified type) Q89.9
    ICD-10-CM Diagnosis Code Q89.9

    Congenital malformation, unspecified

      2016 2017 2018 2019 2020 2021 Billable/Specific Code POA Exempt
    Applicable To
    • Congenital anomaly NOS
    • Congenital deformity NOS
    • palate Q38.5 (hard) (soft)
    • uvula Q38.5
  • Deformity Q89.9
    ICD-10-CM Diagnosis Code Q89.9

    Congenital malformation, unspecified

      2016 2017 2018 2019 2020 2021 Billable/Specific Code POA Exempt
    Applicable To
    • Congenital anomaly NOS
    • Congenital deformity NOS
    • palate (congenital) Q38.5
    • uvula Q38.5 (congenital)
  • Flaccid - see also condition
    • palate, congenital Q38.5
  • High
    • arch
      • palate, congenital Q38.5
    • palate, congenital Q38.5
  • Malformation (congenital) - see also Anomaly
    • palate Q38.5
  • Short, shortening, shortness
    • palate, congenital Q38.5
    • uvula, congenital Q38.5

ICD-10-CM Codes Adjacent To Q38.5
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
Q39.1 Atresia of esophagus with tracheo-esophageal fistula
Q39.2 Congenital tracheo-esophageal fistula without atresia
Q39.3 Congenital stenosis and stricture of esophagus
Q39.4 Esophageal web
Q39.5 Congenital dilatation of esophagus

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