Chapter X Diseases of the Respiratory System

Question 1

The content of which Chapter X standard is permissible to access during NCCQ examination?

Answer 1

DCS X.5 contains the COPD table, which is allowed to access during NCCQ

Question 2

How must recurrent tonsillitis be classified: using ‘acute tonsillitis’ code or using ‘chronic tonsillitis’ code?

Answer 2

J03.9 Acute tonsillitis, unspecified DCS X.1
NB lead term ‘tonsillitis’ does not have a modifier ‘recurrent’, classification therefore defaults to J03.9. Recurrent tonsillitis refers to multiple distinct episodes of acute tonsillitis (standard guidance)

Question 3

Which category in the Chapter X Diseases of the Respiratory System requires the use of 5th characters?

Answer 3

Category J96 - the fifth character subdivisions used with this category indicate the type of failure and must always be assigned whether the type has been specified (0, 1) or not (9).

Question 4

When is it permissible to assign the code J46.X Status asthmaticus?

Answer 4

Code J46.X must only be assigned when the responsible consultant has documented a diagnosis of:

• Acute severe asthma or
• Status asthmaticus

DCS X.6

Question 5

What are alternative terms for ‘Wheeze due to viral infection’ and how must it be coded?

Answer 5

Alternative terms: viral wheeze,
viral-induced wheeze, viral-associated wheeze or viral illness with wheeze
Code combination:
B34.9 Viral infection, unspecified
R06.2 Wheezing
DCSX.2

Question 6

How must post-procedural pneumonia be coded?

Answer 6

Postprocedural pneumonia must be coded using the body system chapter code that classifies the type of pneumonia followed by a code from category Y83-Y84 Surgical and other medical procedures as the cause of abnormal reaction of the patient, or of later
complication, without mention of misadventure at the time of the procedure DCS X.3

Question 7

How must Influenza A/H1N1 (swine flu) be coded, if there are NO documented manifestations?

Answer 7

J10.1 Influenza with other respiratory manifestations, seasonal influenza virus identified.

DCS X.4

Question 8

When coding Influenza A/H1N1 (also known as swine flu), what would the 4th character assignment depend on?

Answer 8

. Fourth character assignment is dependent on whether there are any documented manifestations.

DCS X.4

Question 9

When the cause of Respiratory Failure is known, only the cause must be coded. Is this statement True or False?

Answer 9

False. Respiratory failure must always be coded when the diagnosis is recorded in the medical record. When documented with another respiratory condition, the sequencing will be dependent on the main condition being treated.

DCS X.7

Question 10

What is Influenza A/H1N1 also known as?

Answer 10

Swine Flu

DCS X.4

Question 11

Both statements ‘chest infection’ and ‘pneumonia’ have separate index trails and devoted codes. When both are present in the medical record, should both be coded?

Answer 11

The term ‘Chest infection’ is a non-specific diagnosis; this can be written as a proxy for a more definitive respiratory diagnosis such as pneumonia or bronchiectasis. If a more definitive diagnosis is made (e.g. pneumonia), this should be coded instead of the chest infection. Any uncertainty must be referred back to the responsible consultant.

(Chapter guidance)