ICD-10-CM 2027 diagnosis code
Q38.6Other congenital malformations of mouth
Q38.6 is a valid, billable ICD-10-CM code for other congenital malformations of mouth. It can be reported on claims for dates of service from October 1, 2026 – September 30, 2027.
Looking up by condition? See ICD-10 code for Acheilia.
Code unchanged since ICD-10-CM took effect on October 1, 2015. Source: official FY2027 ICD-10-CM release from CDC/NCHS and CMS. Page updated September 29, 2026. About our data
About Q38.6
Q38.6 is the ICD-10-CM diagnosis code for other congenital malformations of mouth. It belongs to category Q38 (other congenital malformations of tongue, mouth and pharynx), block Q38-Q45 (other congenital malformations of the digestive system) and chapter 17 (congenital malformations, deformations, chromosomal abnormalities, and genetic disorders). It is billable, so it can be reported on its own for dates of service from October 1, 2026 through September 30, 2027.
Within Q38, choose Q38.6 (Other congenital malformations of mouth) only when documentation doesn't support a more specific option: congenital malformations of lips, not elsewhere classified (Q38.0), Ankyloglossia (Q38.1), Macroglossia (Q38.2), other congenital malformations of tongue (Q38.3), congenital malformations of salivary glands and ducts (Q38.4), congenital malformations of palate, not elsewhere classified (Q38.5), congenital pharyngeal pouch (Q38.7) and other congenital malformations of pharynx (Q38.8).
It is not a CC or MCC, so as a secondary diagnosis it doesn't change the MS-DRG severity level.
In MS-DRG v44.0, it is part of the grouping logic for DRG 011 (Tracheostomy for Face, Mouth and Neck Diagnoses or Laryngectomy with MCC, relative weight 5.6154), DRG 012 (Tracheostomy for Face, Mouth and Neck Diagnoses or Laryngectomy with CC, relative weight 4.381), DRG 013 (Tracheostomy for Face, Mouth and Neck Diagnoses or Laryngectomy without CC/MCC, relative weight 2.7307), DRG 157 (Dental and Oral Diseases with MCC, relative weight 1.809), DRG 158 (Dental and Oral Diseases with CC, relative weight 0.9366) and DRG 159 (Dental and Oral Diseases without CC/MCC, relative weight 0.6893), in Pre-MDC and MDC 03 (Diseases and Disorders of the Ear, Nose, Mouth and Throat), as a principal or secondary diagnosis. The DRG a claim lands in depends on the principal diagnosis, procedures and any CC/MCC secondary diagnoses.
It is exempt from present-on-admission (POA) reporting, so no POA indicator is required.
It has been part of ICD-10-CM since the code set took effect on October 1, 2015 and hasn't changed since.
Before ICD-10, this condition was coded in ICD-9-CM as 750.26 (other specified anomalies of mouth).
Coding notes
- Congenital malformation of mouth NOS
Notes that apply from higher levels
Instructions written at a parent level also apply to Q38.6.
Broader instructions also apply from Chapter 17: Congenital malformations, deformations, chromosomal abnormalities, and genetic disorders.
Alphabetic index entries
22 entriesTerms in the official ICD-10-CM index that lead to Q38.6.
- Aberrant (congenital) › sebaceous glands, mucous membrane, mouth, congenital
- Absence (of) (organ or part) (complete or partial) › lip
- Acheilia
- Anomaly, anomalous (congenital) (unspecified type) › gum
- Anomaly, anomalous (congenital) (unspecified type) › mouth
- Aplasia › alveolar process (acquired) › congenital
- Cyst (colloid) (mucous) (simple) (retention) › congenital NEC › sublingual
- Cyst (colloid) (mucous) (simple) (retention) › congenital NEC › submaxillary gland
- Deformity › mouth (acquired) › congenital
- Disease, diseased › Fordyce's (ectopic sebaceous glands) (mouth)
- Ectopic, ectopia (congenital) › sebaceous glands of mouth
- Elongated, elongation (congenital) › uvula
- Fordyce's disease (mouth)
- Islands of › parotid tissue in › lymph nodes
- Islands of › parotid tissue in › neck structures
- Islands of › submaxillary glands in › fascia
- Islands of › submaxillary glands in › lymph nodes
- Islands of › submaxillary glands in › neck muscles
- Malformation (congenital) › gum
- Malformation (congenital) › mouth (congenital)
- Nevus › mouth (mucosa) › white sponge
- Nevus › oral mucosa › white sponge
MS-DRG v44.0 grouping
All DRGs →Inpatient MS-DRGs this diagnosis can group to, as the principal or a secondary diagnosis, depending on the rest of the claim.
MDC PRE · Pre-MDC
MDC 03 · Diseases and Disorders of the Ear, Nose, Mouth and Throat
ICD-9-CM equivalent
Converter →- 750.26Other specified anomalies of mouthapproximate
From the CMS 2018 General Equivalence Mappings (GEMs), the final GEMs release.
Code history
- 2016
- 2017
- 2018
- 2019
- 2020
- 2021
- 2022
- 2023
- 2024
- 2025
- 2026
- 2027
- FY2016 (effective 10/1/2015): Added (first year of ICD-10-CM)
- No changes since FY2016.
Common questions about Q38.6
Is Q38.6 billable?
- Yes. Q38.6 is a billable/specific ICD-10-CM code valid for FY2027 (October 1, 2026 – September 30, 2027).
Can Q38.6 be used as a principal diagnosis?
- Yes. The Medicare Code Editor doesn't restrict Q38.6 as a principal diagnosis.
Is Q38.6 a CC or MCC?
- No. Q38.6 is neither a CC nor an MCC under MS-DRG v44.0.
What DRG does Q38.6 group to?
- Q38.6 is used in the MS-DRG v44.0 logic for MS-DRG 011 (Tracheostomy for Face, Mouth and Neck Diagnoses or Laryngectomy with MCC), MS-DRG 012 (Tracheostomy for Face, Mouth and Neck Diagnoses or Laryngectomy with CC), MS-DRG 013 (Tracheostomy for Face, Mouth and Neck Diagnoses or Laryngectomy without CC/MCC), MS-DRG 157 (Dental and Oral Diseases with MCC), MS-DRG 158 (Dental and Oral Diseases with CC) and MS-DRG 159 (Dental and Oral Diseases without CC/MCC). Which one applies depends on whether it is the principal diagnosis and on the rest of the claim.
What is the ICD-9 code for Q38.6?
- The CMS General Equivalence Mappings map Q38.6 to ICD-9-CM 750.26.