NCCQ UK THEORY EXAM PRACTICE QUESTIONS AND CORRECT
ANSWERS LATEST 2026
TABLE OF CONTENTS
● SECTION 1: ICD-10 Coding Standards
● SECTION 2: OPCS-4 Procedural Coding
● SECTION 3: Anatomy & Physiology
● SECTION 4: Medical Terminology
● SECTION 5: SNOMED CT & Classifications
● SECTION 6: Specialty-Specific Guidelines
● SECTION 7: Practice Questions
SECTION 1: ICD-10 CODING STANDARDS
1.1 Core Structure & Classification
● Q: What are the THREE types of chapters in ICD-10 classification? [3
marks]
A: 1. Special Group Chapters 2. Body System Chapters 3. Other Chapters
● Q: When there is doubt about where a condition should be coded, which
chapter type takes priority? [1 marks]
A: Special Group chapters must take priority
● Q: What is the minimum character length for a valid ICD-10 code? [5
marks]
A: Four characters. Three-character category codes must be subdivided into
four-character subcategories. Where not subdivided, the 'X' filler must be
assigned in the fourth character field (e.g., M45.X3)
💡 KEY CONCEPT: Point-Dash Notation (.-)
, Found in both Tabular List and Alphabetical Index
Indicates there are fourth character subdivisions available
Signals the coder to look for more specific codes
1.2 Fifth Character Usage
● Q: Which FOUR ICD-10 chapters require national collection of fifth
characters? [3 marks]
A: • 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
1.3 Poisoning vs. Adverse Effects
● Q: Name the TWO ways drug/medication reactions are classified in
ICD-10 Tabular List Volume 1 [2 marks]
A: 1. Poisoning (improper use) 2. Adverse effect (proper use)
1.4 Primary Diagnosis Rules
⚠️ CRITICAL: Definition of Primary Diagnosis
The main condition treated or investigated during the relevant episode of
healthcare
Where no definitive diagnosis exists: use main symptom, abnormal finding, or
problem
Must be recorded in the first diagnosis field of the coded clinical record
● Q: What THREE terms permit a coder to accept a condition as a
diagnosis? [3 marks]
A: 1. Working diagnosis 2. Treat as 3. Presumed 4. Probable (Any three of
these)
,1.5 Sequencing Rules
● Q: How should 'severe sepsis' alone be coded? [2 marks]
A: Must code TWO conditions: 1. (A41.9) Sepsis (unspecified) 2. (R65.1)
Systemic Inflammatory Response Syndrome (SIRS) of infectious origin with
organ failure
● Q: How should injury from a geriatric fall be coded and sequenced? [4
marks]
A: 1. Code classifying the injury (from Chapter XIX) 2. External cause code
for the fall (W00-W19) 3. (R29.6) Tendency to fall, NEC Sequencing:
Unless patient remains for falls investigation (becoming primary focus),
R29.6 must be sequenced BEFORE the injury codes
● Q: When should codes from Z54.- Convalescence be assigned and how
sequenced? [2 marks]
A: NEVER in primary position. Only assigned in secondary position when
patient has received convalescence in a dedicated convalescent unit
1.6 Specific Conditions
● Q: What precise wording (other than 'status asthmaticus') permits
assignment of J46.X Status asthmaticus? [1 marks]
A: Acute severe asthma
● Q: Name the TWO specific forms of chest pain categorized to R07 Pain
in throat and chest [2 marks]
A: 1. Central chest pain 2. Musculoskeletal chest pain
🔍 IMPORTANT: Rectal vs Per Rectal Hemorrhage
(K62.5) Hemorrhage of anus and rectum:
→ Use ONLY for actual hemorrhage OF the anus/rectum
→ NOT for hemorrhage from elsewhere exiting via rectum
(K92.2) Gastrointestinal hemorrhage, unspecified:
→ Use for hemorrhage via rectum (per rectal) not specified as from actual
rectum/anus
→ Do NOT assign when it's a symptom of a diagnosed specific disease
,
ANSWERS LATEST 2026
TABLE OF CONTENTS
● SECTION 1: ICD-10 Coding Standards
● SECTION 2: OPCS-4 Procedural Coding
● SECTION 3: Anatomy & Physiology
● SECTION 4: Medical Terminology
● SECTION 5: SNOMED CT & Classifications
● SECTION 6: Specialty-Specific Guidelines
● SECTION 7: Practice Questions
SECTION 1: ICD-10 CODING STANDARDS
1.1 Core Structure & Classification
● Q: What are the THREE types of chapters in ICD-10 classification? [3
marks]
A: 1. Special Group Chapters 2. Body System Chapters 3. Other Chapters
● Q: When there is doubt about where a condition should be coded, which
chapter type takes priority? [1 marks]
A: Special Group chapters must take priority
● Q: What is the minimum character length for a valid ICD-10 code? [5
marks]
A: Four characters. Three-character category codes must be subdivided into
four-character subcategories. Where not subdivided, the 'X' filler must be
assigned in the fourth character field (e.g., M45.X3)
💡 KEY CONCEPT: Point-Dash Notation (.-)
, Found in both Tabular List and Alphabetical Index
Indicates there are fourth character subdivisions available
Signals the coder to look for more specific codes
1.2 Fifth Character Usage
● Q: Which FOUR ICD-10 chapters require national collection of fifth
characters? [3 marks]
A: • 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
1.3 Poisoning vs. Adverse Effects
● Q: Name the TWO ways drug/medication reactions are classified in
ICD-10 Tabular List Volume 1 [2 marks]
A: 1. Poisoning (improper use) 2. Adverse effect (proper use)
1.4 Primary Diagnosis Rules
⚠️ CRITICAL: Definition of Primary Diagnosis
The main condition treated or investigated during the relevant episode of
healthcare
Where no definitive diagnosis exists: use main symptom, abnormal finding, or
problem
Must be recorded in the first diagnosis field of the coded clinical record
● Q: What THREE terms permit a coder to accept a condition as a
diagnosis? [3 marks]
A: 1. Working diagnosis 2. Treat as 3. Presumed 4. Probable (Any three of
these)
,1.5 Sequencing Rules
● Q: How should 'severe sepsis' alone be coded? [2 marks]
A: Must code TWO conditions: 1. (A41.9) Sepsis (unspecified) 2. (R65.1)
Systemic Inflammatory Response Syndrome (SIRS) of infectious origin with
organ failure
● Q: How should injury from a geriatric fall be coded and sequenced? [4
marks]
A: 1. Code classifying the injury (from Chapter XIX) 2. External cause code
for the fall (W00-W19) 3. (R29.6) Tendency to fall, NEC Sequencing:
Unless patient remains for falls investigation (becoming primary focus),
R29.6 must be sequenced BEFORE the injury codes
● Q: When should codes from Z54.- Convalescence be assigned and how
sequenced? [2 marks]
A: NEVER in primary position. Only assigned in secondary position when
patient has received convalescence in a dedicated convalescent unit
1.6 Specific Conditions
● Q: What precise wording (other than 'status asthmaticus') permits
assignment of J46.X Status asthmaticus? [1 marks]
A: Acute severe asthma
● Q: Name the TWO specific forms of chest pain categorized to R07 Pain
in throat and chest [2 marks]
A: 1. Central chest pain 2. Musculoskeletal chest pain
🔍 IMPORTANT: Rectal vs Per Rectal Hemorrhage
(K62.5) Hemorrhage of anus and rectum:
→ Use ONLY for actual hemorrhage OF the anus/rectum
→ NOT for hemorrhage from elsewhere exiting via rectum
(K92.2) Gastrointestinal hemorrhage, unspecified:
→ Use for hemorrhage via rectum (per rectal) not specified as from actual
rectum/anus
→ Do NOT assign when it's a symptom of a diagnosed specific disease
,
