Most hospitals have a good process in place to submit Medicare Indirect Medical Education (IME) shadow bills to CMS for patients registered under Medicare Advantage plans, but issues can still occur resulting in underpayment.
Cleft lip and cleft palate occur when tissues in the baby's face and mouth don't fuse properly. Normally, the tissues that make up the lip and palate fuse together in the second and third months of pregnancy. But in babies with cleft lip and cleft palate, the fusion never takes place or occurs only part way, leaving an opening (cleft). Researchers believe that most cases of cleft lip and cleft palate are caused by an interaction of genetic and environmental factors. In many babies, a definite cause isn't discovered.
A cleft is a split or fissure. So a cleft lip is a split in the upper lip, between the mouth and nose. Some children have only a small notch in the lip, whereas others have a more pronounced cleft. In babies with a severe cleft, there is a complete separation extending from the lip to the nose (Tolarova 2009) . A cleft palate is when the roof of a baby's mouth has not joined completely, leaving a gap. It can happen with or without a cleft lip. Babies are affected differently.