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2025 ICD-10-CM code Q38.2

Macroglossia, a congenital enlargement of the tongue.

Codes from chapter Q are not for use on maternal records.Appropriate diagnostic confidence indicators (A, G, V, or Z) should be appended to the code in outpatient settings.

Medical necessity for management of macroglossia is established when the condition significantly impacts the patient's feeding, breathing, speech, or overall well-being. Severe macroglossia necessitating surgical intervention requires clear clinical justification based on symptoms and functional limitations.

Diagnosis and management of macroglossia often involves a multidisciplinary team including pediatricians, geneticists, oral surgeons, speech therapists, and possibly airway specialists.The clinical responsibility involves assessment of the severity of the macroglossia, determination of any underlying causes, and the development of a management plan tailored to the individual patient.

IMPORTANT:This code is a sub-category under Q38, "Other congenital malformations of tongue, mouth and pharynx."Related codes within Q38 include Q38.1 (Ankyloglossia) and other specific tongue malformations.

In simple words: Macroglossia is a birth defect where a baby's tongue is larger than normal. This can make it hard to breastfeed, speak clearly, or breathe easily. The size of the tongue can range from slightly larger to very large.

Q38.2, Macroglossia, refers to the congenital hypertrophy (enlargement) of the tongue.This condition is characterized by an abnormally large tongue, which can be caused by various genetic or developmental factors. The size of the enlargement can vary significantly, ranging from mildly noticeable to severely impacting oral function and airway patency.Associated symptoms can include difficulty with breastfeeding, speech articulation problems, airway obstruction, and dental issues.

Example 1: A newborn infant presents with significant difficulty breastfeeding due to a large tongue. Examination reveals macroglossia, and further investigations are undertaken to rule out any underlying genetic syndromes. Management includes feeding strategies and potential surgical intervention., A child with macroglossia experiences difficulties with speech articulation and is referred to a speech-language pathologist for therapy. The enlarged tongue is managed conservatively with ongoing monitoring., An adult with moderate macroglossia develops obstructive sleep apnea.An evaluation is conducted by a sleep specialist who recommends surgical intervention to reduce the tongue size and improve airway patency.

Complete history and physical examination documenting the size and impact of the macroglossia.Documentation of any associated symptoms (feeding difficulties, speech impairment, airway obstruction, dental problems).Results of any relevant investigations (genetic testing, imaging studies).Details of the management plan, including any surgical interventions or therapeutic approaches.

** Macroglossia can be an isolated finding or associated with various genetic syndromes.The severity of the condition and the need for intervention should be carefully considered on a case-by-case basis.

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