NCCQ UK THEORY PAST UPDATED ACTUAL QUESTIONS
AND CORRECT ANSWERS
Question:
The requirement for national collection of the use of fifth characters appears in which
four ICD-10 4th Edition chapters? Either chapter numbers (Arabic or Roman numeral)
or full titles are acceptable. [3 Marks]
Answer:
Chapter IX (9) Diseases of the circulatory system Chapter X (10) Diseases of the
respiratory system Chapter XIII (13) Diseases of the musculoskeletal system and
connective tissue Chapter XIX (19) Injury, poisoning and certain other consequences of
external causes
Question:
The circumstances surrounding reactions to drug/medication are classified in two ways
within ICD-10 Tabular List, Volume 1. Name both
ways. [2 Marks]
Answer:
Poisoning (improper use) Adverse effect (proper use)
Question:
What must a coder do if a surgical eponym is used in the medical record to describe a
procedure? [3 Marks]
Answer:
The coder must analyse the procedural information and ensure that code assignment
fully reflects the procedure performed. Where the coder is unsure what procedure the
eponym describes, they must seek advice from the responsible consultant to ensure
that the correct codes are assigned.
Question:
When should site codes from Chapter Z be assigned? [1 Mark]
Answer:
They must always be assigned when this adds further information about the site on
which the procedure was performed
Question:
What two conditions must be coded if a diagnosis of 'severe sepsis' alone is made by the
clinician? No actual codes are required. [2 Marks]
Answer:
(A41.9) Sepsis (unspecified) (R65.1) Systemic Inflammatory Response Syndrome
(SIRS) of infectious origin with organ failure
,Question:
What is the standard regarding the use of the OPCS-4.7 code X35.1 Intravenous
induction of labour? [1 Mark]
Answer:
It must never be used.
Question:
On what occasion is it a mandatory requirement to assign an OPCS-4.7 general
anaesthetic code? [1 Mark]
Answer:
When radiotherapy is delivered under general anaesthetic, a code from category Y80
General anaesthetic must be assigned in addition to the radiotherapy delivery.
Question:
When should codes from ICD-10 category Z54.- Convalescence be assigned and how
should they be sequenced? No actual codes are required. [2 Marks]
Answer:
Never in primary. They must only be assigned in a secondary position when a patient
has received convalescence in a dedicated convalescent unit.
Question:
How should an injury caused by a geriatric fall be coded? Describe the possible
sequencing of these codes. No actual codes are required. [4 Marks]
Answer:
Code classifying the injury sustained (from Chapter XIX). External cause code to
describe the fall (from categories W00-W19). (R29.6) Tendency to fall, (not elsewhere
classified). In this sequence, unless the patient remains in hospital for investigation of
the falls and this becomes the primary focus of care, then this code (R29.6) must be
sequenced before the codes for the injury
Question:
What must be coded when an excision and biopsy (excision
biopsy) is performed on the same site during the same theatre visit, and why? No actual
codes are required. [2 Marks]
Answer:
Only assign a code(s) for the excision as a biopsy is an integral part of an excision.
Question:
When must codes from ICD-10 category Z38.- Liveborn infants according to place of
birth be assigned in the primary coding field? [1 Mark]
Answer:
If the baby is a completely well baby and has no morbid conditions that have been
treated or investigated.
,Question:
During which procedure should OPCS-4.7 code X50.5 Evaluation of a cardiodefibrillator
not be assigned when carried out? No actual codes are
required. [1 Mark]
Answer:
When testing is performed during the insertion of the cardioverter defibrillator (K59
Cardioverter defibrillator introduced through the vein or K72 Other cardioverter
defibrillator).
Question:
What precise wording, other than 'status asthmaticus', must be present in the medical
records to be able to assign J46.X Status asthmaticus? [1 Mark]
Answer:
Acute severe asthma
Question:
How should a fracture fixation procedure be coded when the description names more
than one type of fixation device, e.g. pin and plate? No actual codes are required. [2
Marks]
Answer:
Only the main part of the device that is holding the fracture together must be coded.
When it is not clear which part of the fixation device is the main part holding the
fracture together, advice must be sought from the responsible consultant.
Question:
In accordance with national clinical coding standards, name the two specific forms of
chest pain categorised to ICD-10 category R07 Pain in throat and chest. [2 Marks]
Answer:
Central chest pain Musculoskeletal chest pain
Question:
In ICD-10 coding terms, describe the difference between a 'rectal haemorrhage' and 'per
rectal haemorrhage', and the coding standards related to these
terms. No actual codes are required. [3 Marks]
Answer:
The code (K62.5) for 'haemorrhage of anus and rectum' must only be assigned for an
actual haemorrhage of the anus and/or rectum. It must not be assigned for
haemorrhage that has occurred from elsewhere in the gastrointestinal tract that is
merely exiting via the rectum, i.e. per rectal haemorrhage. The code (K92.2) for
'gastrointestinal haemorrhage, unspecified' must be assigned for a haemorrhage that
occurred via the rectum (per rectal haemorrhage) but is not specified as being from the
actual rectum or anus. This code must not be assigned when it is a symptom of a
specific disease which has been diagnosed.
, Question:
How must a colonoscopy with ileal intubation that includes a biopsy of the terminal
ileum be coded? No actual codes are required. [2 Marks]
Answer:
(H22.1) Diagnostic fibreoptic endoscopic examination of colon and biopsy of lesion of
colon followed by the site code (Z27.6) Ileum
Question:
What clinical coding standards relating to the use of ICD-10 category O63 Long labour
must the coder be aware of? [2 Marks]
Answer:
It must be documented in the medical record that the labour or stage of labour is
prolonged/long for this category to be used. If the reason for the prolonged/long labour
is stated, then this must be coded instead
Question:
When must the insertion of a nasogastric (NG) feeding tube be coded? [1 Mark]
Answer:
When a patient is admitted solely for the purpose of insertion.
Question:
What is the OPCS-4 standard when a gastroscope is not able to be inserted further than
the patient's mouth during an endoscopy? No actual codes are required. [1 Mark]
Answer:
The procedure must not be coded.
Question:
The ICD-10 classification contains 22 chapters and is divided into three different
chapter types. Name the three types of chapter. [3 Marks]
Answer:
Special group chapters Body system chapters Other chapters
Question:
When there is doubt as to where a condition should be coded which of the three
chapter types found in the axis of the ICD-10 classification takes priority? [1 Mark]
Answer:
Where there is any doubt as to where a condition should be coded, the 'special group'
chapters must take priority.
AND CORRECT ANSWERS
Question:
The requirement for national collection of the use of fifth characters appears in which
four ICD-10 4th Edition chapters? Either chapter numbers (Arabic or Roman numeral)
or full titles are acceptable. [3 Marks]
Answer:
Chapter IX (9) Diseases of the circulatory system Chapter X (10) Diseases of the
respiratory system Chapter XIII (13) Diseases of the musculoskeletal system and
connective tissue Chapter XIX (19) Injury, poisoning and certain other consequences of
external causes
Question:
The circumstances surrounding reactions to drug/medication are classified in two ways
within ICD-10 Tabular List, Volume 1. Name both
ways. [2 Marks]
Answer:
Poisoning (improper use) Adverse effect (proper use)
Question:
What must a coder do if a surgical eponym is used in the medical record to describe a
procedure? [3 Marks]
Answer:
The coder must analyse the procedural information and ensure that code assignment
fully reflects the procedure performed. Where the coder is unsure what procedure the
eponym describes, they must seek advice from the responsible consultant to ensure
that the correct codes are assigned.
Question:
When should site codes from Chapter Z be assigned? [1 Mark]
Answer:
They must always be assigned when this adds further information about the site on
which the procedure was performed
Question:
What two conditions must be coded if a diagnosis of 'severe sepsis' alone is made by the
clinician? No actual codes are required. [2 Marks]
Answer:
(A41.9) Sepsis (unspecified) (R65.1) Systemic Inflammatory Response Syndrome
(SIRS) of infectious origin with organ failure
,Question:
What is the standard regarding the use of the OPCS-4.7 code X35.1 Intravenous
induction of labour? [1 Mark]
Answer:
It must never be used.
Question:
On what occasion is it a mandatory requirement to assign an OPCS-4.7 general
anaesthetic code? [1 Mark]
Answer:
When radiotherapy is delivered under general anaesthetic, a code from category Y80
General anaesthetic must be assigned in addition to the radiotherapy delivery.
Question:
When should codes from ICD-10 category Z54.- Convalescence be assigned and how
should they be sequenced? No actual codes are required. [2 Marks]
Answer:
Never in primary. They must only be assigned in a secondary position when a patient
has received convalescence in a dedicated convalescent unit.
Question:
How should an injury caused by a geriatric fall be coded? Describe the possible
sequencing of these codes. No actual codes are required. [4 Marks]
Answer:
Code classifying the injury sustained (from Chapter XIX). External cause code to
describe the fall (from categories W00-W19). (R29.6) Tendency to fall, (not elsewhere
classified). In this sequence, unless the patient remains in hospital for investigation of
the falls and this becomes the primary focus of care, then this code (R29.6) must be
sequenced before the codes for the injury
Question:
What must be coded when an excision and biopsy (excision
biopsy) is performed on the same site during the same theatre visit, and why? No actual
codes are required. [2 Marks]
Answer:
Only assign a code(s) for the excision as a biopsy is an integral part of an excision.
Question:
When must codes from ICD-10 category Z38.- Liveborn infants according to place of
birth be assigned in the primary coding field? [1 Mark]
Answer:
If the baby is a completely well baby and has no morbid conditions that have been
treated or investigated.
,Question:
During which procedure should OPCS-4.7 code X50.5 Evaluation of a cardiodefibrillator
not be assigned when carried out? No actual codes are
required. [1 Mark]
Answer:
When testing is performed during the insertion of the cardioverter defibrillator (K59
Cardioverter defibrillator introduced through the vein or K72 Other cardioverter
defibrillator).
Question:
What precise wording, other than 'status asthmaticus', must be present in the medical
records to be able to assign J46.X Status asthmaticus? [1 Mark]
Answer:
Acute severe asthma
Question:
How should a fracture fixation procedure be coded when the description names more
than one type of fixation device, e.g. pin and plate? No actual codes are required. [2
Marks]
Answer:
Only the main part of the device that is holding the fracture together must be coded.
When it is not clear which part of the fixation device is the main part holding the
fracture together, advice must be sought from the responsible consultant.
Question:
In accordance with national clinical coding standards, name the two specific forms of
chest pain categorised to ICD-10 category R07 Pain in throat and chest. [2 Marks]
Answer:
Central chest pain Musculoskeletal chest pain
Question:
In ICD-10 coding terms, describe the difference between a 'rectal haemorrhage' and 'per
rectal haemorrhage', and the coding standards related to these
terms. No actual codes are required. [3 Marks]
Answer:
The code (K62.5) for 'haemorrhage of anus and rectum' must only be assigned for an
actual haemorrhage of the anus and/or rectum. It must not be assigned for
haemorrhage that has occurred from elsewhere in the gastrointestinal tract that is
merely exiting via the rectum, i.e. per rectal haemorrhage. The code (K92.2) for
'gastrointestinal haemorrhage, unspecified' must be assigned for a haemorrhage that
occurred via the rectum (per rectal haemorrhage) but is not specified as being from the
actual rectum or anus. This code must not be assigned when it is a symptom of a
specific disease which has been diagnosed.
, Question:
How must a colonoscopy with ileal intubation that includes a biopsy of the terminal
ileum be coded? No actual codes are required. [2 Marks]
Answer:
(H22.1) Diagnostic fibreoptic endoscopic examination of colon and biopsy of lesion of
colon followed by the site code (Z27.6) Ileum
Question:
What clinical coding standards relating to the use of ICD-10 category O63 Long labour
must the coder be aware of? [2 Marks]
Answer:
It must be documented in the medical record that the labour or stage of labour is
prolonged/long for this category to be used. If the reason for the prolonged/long labour
is stated, then this must be coded instead
Question:
When must the insertion of a nasogastric (NG) feeding tube be coded? [1 Mark]
Answer:
When a patient is admitted solely for the purpose of insertion.
Question:
What is the OPCS-4 standard when a gastroscope is not able to be inserted further than
the patient's mouth during an endoscopy? No actual codes are required. [1 Mark]
Answer:
The procedure must not be coded.
Question:
The ICD-10 classification contains 22 chapters and is divided into three different
chapter types. Name the three types of chapter. [3 Marks]
Answer:
Special group chapters Body system chapters Other chapters
Question:
When there is doubt as to where a condition should be coded which of the three
chapter types found in the axis of the ICD-10 classification takes priority? [1 Mark]
Answer:
Where there is any doubt as to where a condition should be coded, the 'special group'
chapters must take priority.
