2025 ICD-10-CM code Q35
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Congenital malformations - Cleft lip and cleft palate XVII Congenital malformations, deformations and chromosomal abnormalities (Q00-Q99) Feed
Cleft palate; a fissure in the midline of the hard and/or soft palate due to incomplete fusion during embryonic development.
Modifiers may be applicable to procedures performed to treat the cleft palate, depending on the specific circumstances.
The medical necessity for treatment of cleft palate is established based on the functional impairments caused by the cleft, including difficulties with feeding, speech, hearing, and dental development. Treatment plans usually address these functional limitations.
Diagnosis and treatment of cleft palate may involve multiple specialties, including plastic surgery, otolaryngology, speech-language pathology, and orthodontics. The clinical responsibility depends on the specific aspects of the patient's care.
- XVII Congenital malformations, deformations and chromosomal abnormalities (Q00-Q99)
- Q35-Q37 (Cleft lip and cleft palate)
In simple words: A cleft palate is a birth defect where there's a split in the roof of the mouth.This happens because the two sides of the mouth don't join together properly while the baby is developing in the womb.The split can be in the hard palate (the bony part), the soft palate (the back part), or both.
Q35 signifies a cleft palate, a congenital anomaly characterized by a fissure in the midline of the hard and/or soft palate.This condition arises from the failure of the two palatal shelves to fuse completely during fetal development.The code encompasses various presentations, including clefts of the hard palate (Q35.1), soft palate (Q35.3), both hard and soft palate (Q35.5), and the uvula (Q35.7).Q35.9 is used when the specific location of the cleft is unspecified.This code excludes cleft palate accompanied by cleft lip (coded as Q37.-).
Example 1: A newborn infant presents with a visible cleft in the hard palate.The diagnosis of Q35.1 (Cleft hard palate) is assigned., A child is diagnosed with a cleft in both the hard and soft palate after a comprehensive oral examination.The appropriate code is Q35.5 (Cleft hard palate with cleft soft palate)., During a routine checkup, a pediatrician notes a cleft uvula in an infant.The diagnosis will be recorded as Q35.7 (Cleft uvula).
Detailed clinical notes describing the location and extent of the cleft palate.Documentation should include physical examination findings, images (e.g., photographs or radiographs), and any associated anomalies.
** Always refer to the most current version of the ICD-10-CM coding manual for the most accurate and up-to-date information.
- Payment Status: Active
- Modifier TC rule: Not applicable to this diagnosis code.
- Specialties:Plastic surgery, Otolaryngology, Orthodontics, Speech-language pathology, Pediatric Dentistry
- Place of Service:Office, Hospital (Inpatient or Outpatient), Ambulatory Surgical Center