July is observed as National Cleft and Craniofacial Awareness and Prevention Month (NCCAPM) in the United States. Sponsored by AmeriFace, the nationwide campaign aims to spread awareness about the cleft and craniofacial defects and other conditions. In simple medical terms, the word 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 before they are born. Children with these conditions often have impaired ability to feed and impaired language development, and might be at increased risk for a greater number of ear infections, hearing issues, 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 World Health Organization (WHO) ranks cleft lips, cleft palates and other craniofacial birth defects as first for worldwide recorded birth defects. The exact cause of these facial and oral malformations is unknown. However, a combination of genetic and environmental factors can contribute to this birth disorder. Treatment for these birth defects aims to improve the child’s ability to eat, speak and hear normally and to achieve a normal facial appearance. Medical billing and coding for this condition is challenging, as there are several applicable rules. For accurate clinical documentation of this birth disorder, most otolaryngologists rely on the services of reliable medical billing outsourcing companies.

Reports from the American Cleft Palate and Craniofacial Association (ACPA) suggest that clefts are among the most common problems found in newborn babies in the United States. It is estimated that 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. Many factors that increase the risk of the condition include – family history, diabetes, obesity and exposure to certain substances during pregnancy.

The 2019 NCCAPM campaign aims to educate the public and reduce the stigma associated with orofacial clefts and other similar disorders. Generally, Orofacial clefts (cleft lip, cleft palate, or both) are immediately identifiable at birth, during the initial examination by a pediatrician. A cleft lip and cleft palate may normally appear as a split in the lip and roof of the mouth (palate), a split in the roof of the mouth and a split in the lip that appears as a small notch in the lip or extends from the lip through the upper gum and palate to the bottom of the nose. Common symptoms include chronic ear infections, nasal voice, difficulty with feedings and difficulty swallowing (with potential for liquids or foods to come out the nose).

Most cases of cleft lip and cleft palate can be clearly identified at the time of birth and hence do not require any specific diagnosis tests. However, a pre-natal ultrasound scan can correctly detect facial clefts from around the 13th week of pregnancy. Physicians can detect a difference in the facial structures when analyzing the images of the developing fetus.

If prenatal ultrasound shows a cleft, your physician may suggest a fluid test, to take a sample of amniotic fluid from your uterus (amniocentesis). The test may indicate whether the fetus has inherited a genetic syndrome that may potentially cause any other birth defects. On the other hand, cleft palate that occurs alone is more difficult to view using an ultrasound. Treatment involves surgical techniques to repair cleft lip and palate, and reconstruct the affected areas. 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. The correct medical codes must be used to document the treatment modalities offered by otolaryngologists. Billing and coding services offered by medical billing and coding companies help physicians use the correct codes for their billing purposes.

ICD-10 Codes for 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

This month, organizations and individuals across the country will spread awareness of NCCAPM and the importance of preventing cleft and craniofacial conditions. These conditions include orofacial birth defects as well as conditions acquired as a result of trauma, burns and disease. As part of the campaign, a variety of programs promoting public awareness and offering support to patients and families will be organized. The official color for the 2019 NCCAPM event is “Pink”. By wearing a “Pink ribbon,” people aim to support children born with craniofacial defects in the US and other countries. You can actively participate in this month-long campaign through various social media platforms like Facebook. Throughout the month of July, people can show their support by adding the #SmileMaker frame to their profile picture on Face book.

Observe National Cleft and Craniofacial Awareness and Prevention Month (NCCAPM) this July! Spread awareness about these craniofacial defects, symptoms and treatment options.