ICD-10 Organisation and Structure

Question 1

Give the full title of ICD-10.

Answer 1

International statistical classification of diseases and related health problems 10th revision 5th edition 2016

Question 2

Give the full names of the three volumes of ICD-10

Answer 2

Volume I Tabular List
Volume 2 Instruction Manual
Volume 3 Alphabetical Index

Question 3

How many chapters does ICD-10 Volume 1 contain?

Answer 3

22 Chapters

Question 4

ICD-10 is a variable axis classification. The chapters are grouped by different types.
What are these types and how many chapters are included in each type?

Answer 4

9 chapters covering each of the major body systems (Chapters VI-XIV)
9 chapters devoted to special types of conditions which affect the body
generally (Chapters I-V, XV-XVII and XIX)
4 ‘Other’ chapters (Chapters XVIII, XX, XXI and XXII)

Question 5

In general, conditions are primarily classified to one of the ‘special group’ chapters.
Where there is doubt about where a condition should be positioned which type of
chapter should take priority?

Answer 5

Special group chapters

Question 6

Several chapters span more than one letter in their code range. Which chapters are
these? The full chapter numbers and titles are required.

Answer 6

Chapter I Certain infectious and parasitic diseases (A00-B99)
Chapter II Neoplasms (C00-D48)
Chapter XIX Injury, poisoning and certain other consequences of external
causes (S00-T98)
Chapter XX External causes of morbidity and mortality (V01-Y98)

Question 7

Give the full ICD-10 chapter titles for;

four ‘body system’ chapters

Answer 7

Any of:
Chapter VI Diseases of the nervous system
Chapter VII Diseases of the eye and adnexa
Chapter VIII Diseases of the ear and mastoid process
Chapter IX Diseases of the circulatory system
Chapter X Diseases of the respiratory system
Chapter XI Diseases of the digestive system
Chapter XII Diseases of the skin and subcutaneous tissue
Chapter XIII Diseases of the musculoskeletal system and connective tissue
Chapter XIV Diseases of the genitourinary system

Question 8

Give the full ICD-10 chapter titles for;

four ‘special group’ chapters

Answer 8

Any of:
Chapter I Certain infectious and parasitic diseases
Chapter II Neoplasms
Chapter III Diseases of the blood and blood-forming organs and certain disorders
involving the immune mechanism
Chapter IV Endocrine, nutritional and metabolic diseases
Chapter V Mental and behavioural disorders
Chapter XV Pregnancy, childbirth and the puerperium
Chapter XVI Certain conditions originating in the perinatal period
Chapter XVII Congenital malformations, deformations and chromosomal
abnormalities
Chapter XIX Injury, poisoning and certain other consequences of external causes

Question 9

Give the full ICD-10 chapter titles for;

two ‘other’ chapters

Answer 9

Any of:
Chapter XVIII Symptoms, signs and abnormal clinical and laboratory findings, not
elsewhere classified
Chapter XX External causes of morbidity and mortality
Chapter XXI Factors influencing health status and contact with health services
Chapter XXII Codes for special purposes

Question 10

Chapters are further divided into three divisions, list the divisions with a brief description.

Answer 10

Block – Features a range of three character codes and appears in different sections of each chapter.

Category – Three-character alphanumeric codes are shown in a black box.

Subcategory – Contains 4 characters. Where codes do not have four-character options a filler ‘X’ Is used to ensure all codes are of standard length.

Question 11

What is clinical coding?

Answer 11

Clinical coding is the translation of medical terminology that describes a patient’s
complaint, problem, diagnosis, treatment or other reason for seeking medical attention
into codes that can then be easily tabulated, aggregated and sorted for statistical
analysis in an efficient and meaningful manner.

Question 12

What are the three dimensions of coding accuracy?

Answer 12

Individual codes
Totality of codes
Sequencing of codes

Question 13

In the three dimensions of coding accuracy describe what is meant by Individual codes?

Answer 13

Each clinical statement of diagnosis must have the correct code assignment. An
individual patient may have many diagnoses (or procedures). Consequently a coded record for a consultant episode will have at least one or potentially many individual
codes.

Question 14

In the three dimensions of coding accuracy describe what is meant by Totality of codes?

Answer 14

The concept of totality of codes is complex. It means that all codes necessary to give
an accurate clinical picture of the patient’s diagnosis, problems or other reasons for a consultant episode encounter, must be assigned in accordance with the rules,
conventions and standards of the classification. This is important as it is possible for a list of codes to describe a consultant episode incorrectly in terms of clinical coding rules and standards even though the individual codes themselves are correct

Question 15

In the three dimensions of coding accuracy describe what is meant by Sequencing of codes?

Answer 15

Codes must be sequenced in accordance with clinical coding standards to provide
consistent data for statistical analysis. A significant aspect of sequencing is the
selection of the main condition treated. See also DGCS.1: Primary Diagnosis.

Question 16

What three types of standards are found within the National Clinical Coding
Standards ICD-10 5th Edition reference book?

Answer 16

General coding standards, Chapter standards and Coding standards

Question 17

List 4 of the 7 sections found in ICD-10 Volume 2 Instruction Manual

Answer 17

Section 1 - Introduction
Section 2 - Description of ICD-10
Section 3 - How to use ICD
Section 4 - Rules and guidance
Section 5 - Statistical presentation
Section 6 - History and development of ICD
Section 7- Annexes

Question 18

What is the purpose of Volume 2 of ICD-10?

Answer 18

Volume 2 provides a basic description of the ICD, together with practical instructions
for mortality and morbidity coders, and guidelines for the presentation and
interpretation of data. It is for international use.

Question 19

Which four chapters within ICD-10 have fifth characters mandated for use within the
UK? (Provide the full chapter number and title)

Answer 19

Chapter IX Diseases of the circulatory system
Chapter X Diseases of the respiratory system
Chapter XIII Diseases of the musculoskeletal system and connective tissue
Chapter XIX Injury, poisoning and certain other consequences of external causes

Question 20

In which section of the ICD-10 Alphabetical Index would you find the Table of Drugs
and Chemicals?

Answer 20

Section III of the Alphabetical Index

Question 21

In which section of the Alphabetical Index would you find codes for external causes?

Answer 21

Section II of the Alphabetical Index

Question 22

What is Step 1 of the Four Step Coding Process?

Answer 22

Analyse the medical terminology to determine the lead term(s) and modifier(s)

Question 23

What is Step 2 of the Four Step Coding Process?

Answer 23

Locate the lead term(s) in the ICD-10 Volume 3 – alphabetical index.

Question 24

What is Step 3 of the Four Step Coding Process?

Answer 24

Assign a tentative code(s) using the alphabetical index and taking into account all rules, conventions and standards.

Question 25

What is Step 4 of the Four Step Coding Process?

Answer 25

Verify the code(s) using the ICD-10 Volume 1 – Tabular list, taking into account the instructional notes.

Question 26

What is meant by Coding uniformity

Answer 26

Coding uniformity means that whenever a given condition or reason for a consultant episode is coded, the same code is always used to represent that condition or reason for the encounter.

Question 27

Give an example of a general rule for accurate code selection

Answer 27

Any from:

•Code the minimum number of codes which accurately reflect the patient’s condition during the consultant episode.
• Code every condition or reason for encounter which affects the care, or influences health status during the consultant episode, which is available in the classification and
supported by the medical record.
• Code each problem to the furthest level of specificity, i.e. third, fourth or fifth
character, which is available in the classification and supported by the medical record.
• Do not code background information or chronic problems which are no longer active
and which do not influence the health care being provided in the relevant consultant episode. It is not always intended that symptoms or history be coded. Just because a
condition can be coded does not mean it should be coded each time the patient is admitted. Any uncertainty around issues of relevance should be refered back to the responsible consultant.