The month of July is observed as “National Cleft and Craniofacial Awareness & Prevention Month (NCCAPM)” in the United States. Established by AmeriFace and cleftAdvocate, the campaign aims to spread awareness about the cleft and craniofacial conditions that affect millions of children around the world. The American Cleft Palate and Craniofacial Association (ACPA) reports that cleft lip and/or cleft palate are the two common birth defects found in newborn babies in the United States. The term “craniofacial” is used to describe conditions that affect a person’s head or face. Cleft and craniofacial defects are formed during the development of a baby’s facial structures. The exact cause of these facial and oral malformations is not correctly known. Genetics as well as exposure to certain risk factors that arise during a woman’s pregnancy play a crucial role in developing these isolated birth defects. However, these may also occur due to a combination of inherited syndrome and other lifestyle factors like diabetes, smoking and use of certain medications. Treatment modalities for these birth defects aim to provide a natural facial appearance to the child and improve their individual ability to speak, hear and eat normally. In most cases, a series of surgeries can restore normal function and achieve a more normal facial appearance with minimal scarring. Billing and coding for this genetic facial disorder is challenging as there are several applicable rules and codes. Otolaryngologists treating children with this facial disorder must use the correct diagnosis and procedural codes on their medical claims. For accurate clinical documentation of this birth disorder, otolaryngologists can rely on the services of a reliable medical billing and coding company.

According to reports from the World Health Organization, cleft lip, cleft palate and other craniofacial birth defects rank as first for worldwide recorded birth defects. In the United States alone, cleft lip or cleft palate occurs in almost one out of every 600 to 1,000 births. It is estimated that males are twice likely to have cleft lip, cleft palate, or both as females. Females are more likely to have a cleft palate only. Generally, children with these conditions suffer an impaired ability to feed and impaired ability for language development. Such children may also have a high risk of suffering ear infections, hearing problems and problems with their teeth. Orofacial clefts (cleft lip, cleft palate, or both) are the main, common craniofacial birth defects. Congenital abnormalities that affect the development of the skull (craniosynostosis) and the ears (microtia and anotia) also come under this category.

The 2020 monthly observance aims to highlight awareness and resources about cleft and craniofacial defects and other conditions that can affect the head and face. Symptoms include chronic ear infections, nasal voice, difficulty with feedings and difficulty swallowing. Cleft lip and cleft palate (or both) can be easily identified at birth during the initial examination of the pediatrician and hence do not require any special tests for diagnosis. However, a pre-natal ultrasound scan can properly spot facial clefts from around the 13th week of pregnancy. When analyzing the images of the changing or developing fetus, physicians can easily detect any possible difference in the facial structure or feature.

If the image in a prenatal ultrasound shows a cleft, physicians may further suggest performing a fluid test wherein the sample of amniotic fluid from the uterus (amniocentesis) may be collected for diagnosis. The test could help indicate whether the fetus has inherited a genetic syndrome that may potentially cause any other birth defects. Treatment modalities for this condition involve surgery to repair the birth defect and other therapies to improve any related conditions. Common surgical techniques include cleft lip repair, cleft palate repair, ear tube surgery and additional procedures to reconstruct or improve the appearance of the mouth, lip and nose. While documenting the diagnosis and other treatment modalities offered by otolaryngologists, the correct medical codes must be used. Billing and coding services provided by medical billing companies help physicians use the correct codes for their billing purposes. ICD-10 codes used to diagnose Cleft lip and Cleft palate –

  • 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
  • Q36 – Cleft lip
    • Q36.0 – Cleft lip, bilateral
    • Q36.1 – Cleft lip, median
    • Q36.9 – Cleft lip, unilateral
  • 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 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
  • As part of the 2020 campaign, treatment specialists, support organizations, advocacy groups, affected individuals and families are joining hands this July to encourage awareness of cleft and craniofacial conditions across the country. A variety of programs will be organized which will share patient and family stories and reach out to local communities to share the message. Patient and family stories will be shared via several social media platforms like Facebook, Twitter and Instagram. In support of the initiative, people can post or share “cleft awareness” frame to their social media profiles. The official color for the 2020 NCCAPM event is “Pink”. By wearing a “Pink ribbon,” people aim to support children born with craniofacial defects in the US and other countries.

    Observe NCCAPM this July and generate awareness about these craniofacial birth defects.