Every year, 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 generate widespread awareness about cleft and craniofacial conditions that affect thousands of infants, children, teens and adults in the United States each year. It aims to highlight resources about cleft and craniofacial defects and other conditions that can affect the head and face. Regarded among the most common birth defects, cleft lip and cleft palate develops when the facial structures that are developing in an unborn baby do not join together or don’t close completely during pregnancy. Together, these birth defects are commonly called “orofacial clefts”. Typically, these are openings or splits in the upper lip, the roof of the mouth (palate) or both. In fact, these defects are formed during the development of a baby’s facial structures before they are born. As per reports from the World Health Organization (WHO), cleft lips, cleft palates and other craniofacial birth defects rank as first for worldwide recorded birth defects. Treatment modality includes a series of surgeries that aim to provide a natural facial appearance to the child and improve their ability to speak, hear and eat normally. Medical billing and coding for this genetic facial disorder can be challenging. Otolaryngologists or other physicians providing treatment must use the correct diagnosis and procedural codes on their medical claims. Professional medical billing companies can help providers with accurate clinical documentation of this facial, birth disorder.

The 2021 month-long observance is a unique opportunity to generate awareness about children living with these facial conditions nationwide as well as provide specialized care and resources during the long and challenging treatment regimen. Reports show that cleft lip or cleft palate occurs in almost one out of every 600 to 1,000 births in the United States alone. Craniofacial conditions are present in nearly one out of every 10,000 births. In fact, males are twice as likely to have cleft lip, cleft palate, or both as females. Cleft palate without cleft lip is more common in females. The actual causes behind these facial and oral malformations are not known. However, a combination of factors such as genetics, inherited syndrome, exposure to certain risk factors (during pregnancy period) and other lifestyle factors like diabetes, smoking, and use of certain medications are likely to increase the chances of these conditions.

Generally, a split (cleft) in the lip or palate is immediately identifiable at birth. Cleft lip and cleft palate may appear as – a split in the lip and roof of the mouth (palate) that affects one or both sides of the face, a split in the lip that appears as only a small notch in the lip (or extends from the lip through the upper gum and palate into the bottom of the nose) and a split in the roof of the mouth that doesn’t affect the appearance of the face. Children with this facial malformation may experience difficulty with feedings, difficulty swallowing (with potential for liquids or foods to come out the nose), nasal speaking voice, chronic ear infections, hearing problems, problems with their teeth, speech difficulties and other social, emotional and behavioral problems.

The month-long initiative aims to fund and provide support for hundreds of infants and teens afflicted with congenital cleft lip and cleft palate. Most cases of cleft lip and cleft palate (or both) can be easily noticed right away at birth during the initial examination by a pediatrician and therefore don’t require any special tests for diagnosis. 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. But, cleft palate that occurs alone is more difficult to detect using ultrasound. If the prenatal ultrasound image shows a cleft, physicians may perform a procedure to take a sample of amniotic fluid from the uterus (amniocentesis) – that may indicate whether the fetus has inherited a genetic syndrome that may cause other birth defects.

Treatment modalities for this condition aim to improve a child’s ability to eat, speak and hear normally and to achieve a normal facial appearance. Typically, the treatment involves surgery to repair the defect and 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. Cleft lip repair surgeries will be performed within the first 3 to 6 months of age and cleft palate repair surgeries will be performed by the age of 12 months, or earlier (if possible). Follow-up surgeries will be performed between age 2 and the late teen years. These surgical treatments can significantly improve the child’s appearance, quality of life, and ability to eat, breathe and talk.

Otolaryngologists, ENTs, pediatricians or other physicians treating children with cleft lip and cleft palate disorders must correctly document the diagnosis and treatment modalities performed using the right medical codes. Medical billing outsourcing services can help physicians use the correct codes for their billing purposes. ICD-10 diagnosis 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

During July, the National Cleft and Craniofacial Awareness and Prevention Month, a variety of programs will be organized across the country that promote public awareness and offer support and educational services for patients and their families. Organizations participating in this campaign would arrange a wide range of programs on the local, regional and national levels and devise new ways to collaborate and raise awareness of these conditions. People can participate in this campaign by posting patient and family stories via social media platforms like Facebook, Twitter and Instagram. You can post or share “cleft awareness” frame to your social media profiles. The official color for the 2021 NCCAPM event is “Pink”. You can wear a “Pink ribbon,” to support children born with craniofacial defects in the US and other countries.

Take part in this awareness campaign in July and raise cleft and craniofacial awareness both at the national and the international level.