Billable / Specific Code
ICD-10-CM Q38.5 is the diagnosis code for Congenital malformations of palate, not elsewhere classified. This code falls under the section "Other congenital malformations of the digestive system" within Chapter 17 — Congenital malformations, deformations and chromosomal abnormalities (Q00-QA0). It is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. Medical coders and healthcare providers use this code to document and classify diagnoses in electronic health records, insurance claims, and clinical databases.
The following conditions should never be coded at the same time as Q38.5. They are mutually exclusive:
Understanding where Q38.5 sits in the ICD-10-CM classification helps ensure proper coding:
Yes, Q38.5 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes.
Q38.5 is the ICD-10-CM diagnosis code for "Congenital malformations of palate, not elsewhere classified". It is used by healthcare providers to classify and document this condition in medical records and insurance claims.
The parent code of Q38.5 is Q38 ("Other congenital malformations of tongue, mouth and pharynx"). Q38.5 provides a more specific classification within this category.
Q38.5 is located in Section Q38-Q45 — "Other congenital malformations of the digestive system" within Chapter 17 of the ICD-10-CM Tabular List.
Use Q38.5 when the patients documented diagnosis matches "Congenital malformations of palate, not elsewhere classified" and the clinical documentation supports this level of specificity. Always verify with the latest ICD-10-CM guidelines and payer requirements.
The ICD-10-CM code for Congenital malformations of palate, not elsewhere classified is Q38.5.
Yes, Q38.5 can be used as a primary diagnosis code since it is billable and specific.
Q38.5 is in Chapter 17 of the ICD-10-CM Tabular List.
Type 1 Excludes for Q38.5 include: cleft palate (Q35.-); cleft palate with cleft lip (Q37.-).
Yes, Q38.5 is a valid ICD-10-CM code for the 2026 fiscal year, subject to official CMS updates.