NCCQ UK THEORY PAST PAPER PRACTICE | 322 QUESTIONS | WITH COMPLETE
SOLUTIONS!!
In ICD-10 5th Edition, what two terms are associated with the use of fifth characters when
coding fractured bones, and of these what must be recorded if the type is not indicated? [3
Marks] - -'Open' and 'closed'
An injury not indicated as 'open' or 'closed' must be recorded using fifth character '0'
--In relation to the co-morbidities standard in ICD-10 5th Edition, why will acute conditions
always be coded? - -Acute conditions will always affect the patient's episode of care
--Which one of the following options must an injury be described as to be classified to ICD-
10 5th Edition Chapter XIII Diseases of the musculoskeletal system and connective tissue?
A. Acute, old or recurrent
B. Acute, subacute or recurrent
C. Chronic, old or recurrent - -C. Chronic, old or recurrent
--Codes in categories U00-U49 are reserved by the WHO for provisional assignment in what
situations? [2 Marks] - -New diseases of uncertain aetiology or emergency use
--When is it permissible to assign ICD-10 5th Edition fourth character codes for 'multiple
injuries' in Chapter XIX Injury, poisoning and certain other consequences of external causes?
[3 Marks] - -Only where no detail is documented in the medical record about the individual
sites or types of the injury
--Name the five columns of the 'neoplasm table' found in Volume 3 Alphabetical Index of
ICD-10 5th Edition related to behaviour. [5 Marks] - -Malignant primary
Malignant secondary
In situ
Benign
Uncertain or unknown behaviour
--In ICD-10 5th Edition, the dagger and asterisk system provides a dual classification of
diagnostic statements; what does each symbol represent? [2 Marks] - -The dagger (†)
represents the underlying generalised disease (also referred to as aetiology). The asterisk (*)
represents the manifestation of that disease
--In ICD-10 5th Edition, anaemia must not be coded in what three neoplastic blood disorders
as it is a natural symptom in these conditions? [3 Marks] - -Leukaemia, myeloma and
myelodysplasia
--In ICD-10 5th Edition, what are sequelae codes used to indicate? [2 Marks] - -They are used
to indicate that a current condition or disease has been caused by a previously occurring
disease or injury which has been treated and is no longer present
,--What punctuation is used in both the ICD-10 5th Edition Tabular List and the Alphabetical
Index to indicate there are fourth character subdivisions? - -Point-dash (.-)
--In OPCS-4, what does NOC stand for and in what chapter is it used? [2 Marks] - -NOC
stands for Not Otherwise Classifiable and is used only in the subsidiary Chapter Y.
--Name the four Sections of the OPCS-4 Alphabetical Index. [4 Marks] - -(Alphabetical Index
of) Interventions and Surgical Procedures
(Alphabetical Index of Surgical) Eponyms
(Alphabetical Index of Surgical) Abbreviations
(Alphabetical Index of Common Surgical) Suffixes
--When and how are codes from OPCS-4 Chapter S Skin used to enhance a code from
another body system chapter? [3 Marks] - -The code from Chapter S must be assigned:
• When it provides further information about the procedure that is not specified in the
primary body system code.
• In a secondary position, directly after the body system code it is enhancing
--Describe the OPCS-4 standard for coding excision and biopsy procedures. [4 Marks] - -
When an excision and biopsy is performed on the same site during the same theatre visit,
only assign a code(s) for the excision, as a biopsy is an integral part of the excision
--In which position must codes from OPCS-4 chapters Y Subsidiary Classification of Methods
of Operation and Z Subsidiary Classification of Sites of Operation be sequenced? - -They
must only ever be coded in a secondary position
--In OPCS-4, how should a 'failed intubation' at an upper gastrointestinal tract endoscopy be
reflected in the coded clinical record? [2 Marks] - -The procedure must not be coded unless
the point of abandonment is beyond the mouth
--What is the main axis of classification within OPCS-4 and what are the four levels of
complexity associated with it? [5 Marks] - -The main axis of the classification is body system.
The four levels of complexity are major, intermediate, minor and non-operative
--To maintain the structure of the OPCS-4 classification, .8 and .9 codes are available in both
principal and extended categories, but from which one of these is it acceptable to assign .8
and .9 codes? - -Principal categories
--Describe the standard when coding multiple deliveries (e.g. twins, triplets) in OPCS-4
Chapter R Female Genital Tract Associated with Pregnancy, Childbirth and Puerperium. [3
Marks] - -Each different type of delivery must be recorded with the most serious being
sequenced first. Where all methods of delivery are identical, only one code is required
--Where an unintentional action, such as perforation of an organ, occurs during a procedure,
how should this be reflected in the coded clinical record? The answer should reflect both
ICD-10 5th Edition and OPCS-4. [3 Marks] - -This unintentional action must not be recorded
using OPCS-4 codes. Any surgical procedures performed to correct the unintentional action
, must be recorded using the appropriate OPCS-4 code(s). Any associated diagnosis resulting
from the unintentional action, e.g. accidental perforation of organ, will be coded using the
appropriate ICD-10 code(s)
--In ICD-10 5th Edition, what is the primary diagnosis definition? [7 Marks] - -The first
diagnosis field(s) of the coded clinical record (the primary diagnosis) will contain the main
condition treated or investigated during the relevant episode of healthcare. Where a
definitive diagnosis has not been made by the responsible clinician the main symptom,
abnormal findings, or problem should be recorded in the first diagnosis field of the coded
clinical record
--ICD: Describe the rule in relation to code structure when a three character category is not
subdivided into four character subdivisions, and why this is used. [5 Marks] - -The 'X' filler
must be assigned in the fourth character field so the codes are of a standard length for data
processing and validation. Where a three character code requires assignment of both the 'X'
filler and a fifth character subdivision, the 'X' filler must continue to be recorded in the
fourth field before the fifth character
--ICD: Describe the purpose of 'Use' notes in Volume 1 Tabular List and when the convention
must be applied. [3 Marks] - -The 'use' note is a specific instruction to use an additional code
in order to describe a condition more completely. The 'use' note is never optional and must
always be adhered to where the information is available in the medical record.
--OPCS: Describe the uses of the 'Note' instruction. [5 Marks] - -• To advise coders to include
or omit additional or subsidiary codes.
• To direct coders elsewhere in the classification to more appropriate categories.
• To clarify the intended use of a particular chapter, category or code.
• To provide specific instructions on the correct sequencing of codes when used together
(paired codes)
--OPCS: Describe 'paired codes' and the convention associated with the 'paired codes note'.
[5 Marks] - -Some interventions/procedures are frequently carried out together but are
classified at separate codes or categories. Where this is the case, the categories concerned
contain instructional notes to indicate the associated code and correct sequencing.
The following paired codes notes appear in the OPCS-4 Tabular List:
• 'Use a supplementary code/Use an additional code/Use a subsidiary code' - use the code,
at which this note appears in a primary position.
• 'Use as a supplementary code/Use as an additional code/For use as a subsidiary code/Use
as a secondary code' - use the code, at which this note appears, in a secondary position.
Paired codes may be classified within the same or a different body system chapter. They can
be used alone when only one intervention / procedure is performed
--OPCS: Describe the purpose of 'overflow' categories and how they appear in the Tabular
List and Alphabetical Index. [4 Marks] - -When additional operations/interventions are
required to be classified to that chapter, but the chapter is full; overflow categories are
created at the end of the chapter.
SOLUTIONS!!
In ICD-10 5th Edition, what two terms are associated with the use of fifth characters when
coding fractured bones, and of these what must be recorded if the type is not indicated? [3
Marks] - -'Open' and 'closed'
An injury not indicated as 'open' or 'closed' must be recorded using fifth character '0'
--In relation to the co-morbidities standard in ICD-10 5th Edition, why will acute conditions
always be coded? - -Acute conditions will always affect the patient's episode of care
--Which one of the following options must an injury be described as to be classified to ICD-
10 5th Edition Chapter XIII Diseases of the musculoskeletal system and connective tissue?
A. Acute, old or recurrent
B. Acute, subacute or recurrent
C. Chronic, old or recurrent - -C. Chronic, old or recurrent
--Codes in categories U00-U49 are reserved by the WHO for provisional assignment in what
situations? [2 Marks] - -New diseases of uncertain aetiology or emergency use
--When is it permissible to assign ICD-10 5th Edition fourth character codes for 'multiple
injuries' in Chapter XIX Injury, poisoning and certain other consequences of external causes?
[3 Marks] - -Only where no detail is documented in the medical record about the individual
sites or types of the injury
--Name the five columns of the 'neoplasm table' found in Volume 3 Alphabetical Index of
ICD-10 5th Edition related to behaviour. [5 Marks] - -Malignant primary
Malignant secondary
In situ
Benign
Uncertain or unknown behaviour
--In ICD-10 5th Edition, the dagger and asterisk system provides a dual classification of
diagnostic statements; what does each symbol represent? [2 Marks] - -The dagger (†)
represents the underlying generalised disease (also referred to as aetiology). The asterisk (*)
represents the manifestation of that disease
--In ICD-10 5th Edition, anaemia must not be coded in what three neoplastic blood disorders
as it is a natural symptom in these conditions? [3 Marks] - -Leukaemia, myeloma and
myelodysplasia
--In ICD-10 5th Edition, what are sequelae codes used to indicate? [2 Marks] - -They are used
to indicate that a current condition or disease has been caused by a previously occurring
disease or injury which has been treated and is no longer present
,--What punctuation is used in both the ICD-10 5th Edition Tabular List and the Alphabetical
Index to indicate there are fourth character subdivisions? - -Point-dash (.-)
--In OPCS-4, what does NOC stand for and in what chapter is it used? [2 Marks] - -NOC
stands for Not Otherwise Classifiable and is used only in the subsidiary Chapter Y.
--Name the four Sections of the OPCS-4 Alphabetical Index. [4 Marks] - -(Alphabetical Index
of) Interventions and Surgical Procedures
(Alphabetical Index of Surgical) Eponyms
(Alphabetical Index of Surgical) Abbreviations
(Alphabetical Index of Common Surgical) Suffixes
--When and how are codes from OPCS-4 Chapter S Skin used to enhance a code from
another body system chapter? [3 Marks] - -The code from Chapter S must be assigned:
• When it provides further information about the procedure that is not specified in the
primary body system code.
• In a secondary position, directly after the body system code it is enhancing
--Describe the OPCS-4 standard for coding excision and biopsy procedures. [4 Marks] - -
When an excision and biopsy is performed on the same site during the same theatre visit,
only assign a code(s) for the excision, as a biopsy is an integral part of the excision
--In which position must codes from OPCS-4 chapters Y Subsidiary Classification of Methods
of Operation and Z Subsidiary Classification of Sites of Operation be sequenced? - -They
must only ever be coded in a secondary position
--In OPCS-4, how should a 'failed intubation' at an upper gastrointestinal tract endoscopy be
reflected in the coded clinical record? [2 Marks] - -The procedure must not be coded unless
the point of abandonment is beyond the mouth
--What is the main axis of classification within OPCS-4 and what are the four levels of
complexity associated with it? [5 Marks] - -The main axis of the classification is body system.
The four levels of complexity are major, intermediate, minor and non-operative
--To maintain the structure of the OPCS-4 classification, .8 and .9 codes are available in both
principal and extended categories, but from which one of these is it acceptable to assign .8
and .9 codes? - -Principal categories
--Describe the standard when coding multiple deliveries (e.g. twins, triplets) in OPCS-4
Chapter R Female Genital Tract Associated with Pregnancy, Childbirth and Puerperium. [3
Marks] - -Each different type of delivery must be recorded with the most serious being
sequenced first. Where all methods of delivery are identical, only one code is required
--Where an unintentional action, such as perforation of an organ, occurs during a procedure,
how should this be reflected in the coded clinical record? The answer should reflect both
ICD-10 5th Edition and OPCS-4. [3 Marks] - -This unintentional action must not be recorded
using OPCS-4 codes. Any surgical procedures performed to correct the unintentional action
, must be recorded using the appropriate OPCS-4 code(s). Any associated diagnosis resulting
from the unintentional action, e.g. accidental perforation of organ, will be coded using the
appropriate ICD-10 code(s)
--In ICD-10 5th Edition, what is the primary diagnosis definition? [7 Marks] - -The first
diagnosis field(s) of the coded clinical record (the primary diagnosis) will contain the main
condition treated or investigated during the relevant episode of healthcare. Where a
definitive diagnosis has not been made by the responsible clinician the main symptom,
abnormal findings, or problem should be recorded in the first diagnosis field of the coded
clinical record
--ICD: Describe the rule in relation to code structure when a three character category is not
subdivided into four character subdivisions, and why this is used. [5 Marks] - -The 'X' filler
must be assigned in the fourth character field so the codes are of a standard length for data
processing and validation. Where a three character code requires assignment of both the 'X'
filler and a fifth character subdivision, the 'X' filler must continue to be recorded in the
fourth field before the fifth character
--ICD: Describe the purpose of 'Use' notes in Volume 1 Tabular List and when the convention
must be applied. [3 Marks] - -The 'use' note is a specific instruction to use an additional code
in order to describe a condition more completely. The 'use' note is never optional and must
always be adhered to where the information is available in the medical record.
--OPCS: Describe the uses of the 'Note' instruction. [5 Marks] - -• To advise coders to include
or omit additional or subsidiary codes.
• To direct coders elsewhere in the classification to more appropriate categories.
• To clarify the intended use of a particular chapter, category or code.
• To provide specific instructions on the correct sequencing of codes when used together
(paired codes)
--OPCS: Describe 'paired codes' and the convention associated with the 'paired codes note'.
[5 Marks] - -Some interventions/procedures are frequently carried out together but are
classified at separate codes or categories. Where this is the case, the categories concerned
contain instructional notes to indicate the associated code and correct sequencing.
The following paired codes notes appear in the OPCS-4 Tabular List:
• 'Use a supplementary code/Use an additional code/Use a subsidiary code' - use the code,
at which this note appears in a primary position.
• 'Use as a supplementary code/Use as an additional code/For use as a subsidiary code/Use
as a secondary code' - use the code, at which this note appears, in a secondary position.
Paired codes may be classified within the same or a different body system chapter. They can
be used alone when only one intervention / procedure is performed
--OPCS: Describe the purpose of 'overflow' categories and how they appear in the Tabular
List and Alphabetical Index. [4 Marks] - -When additional operations/interventions are
required to be classified to that chapter, but the chapter is full; overflow categories are
created at the end of the chapter.
