Professional Association of Clinical Coders UK
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Professional Association of Clinical Coders UK
Certificate Examination – Paper 1
Candidate Number: …………………………………………………………………
Date: 30th November 2009
Morning: 3 hours
Instructions to candidates:
· Write your name and your candidate number in the space above
· Answer all questions
· Write your answer in the space provided on the question paper
· Read the instructions carefully to ensure that you know what you have to do before you answer the questions
· If you wish, you may stick a sticker on up to 3 questions where you would have liked to have clarified something before finalising your coding. Against these please say what it was you would have liked to clarify. You must still answer all questions.
Materials required:
· ICD-10 Volume 1. Tabular List
· ICD-10 Volume 3. Index
· OPCS 4.5. Tabular List
· OPCS 4.5. Index
· Chemotherapy Regimens List April 2009
· High Cost Drugs List April 2009
Additional Materials allowed:
· Pocket medical dictionary
· Formulary (BNF, MIMMS)
This paper consists of a total of 12 printed pages and 1 blank page.
Do not turn over until you are told to do so.
Section 1ICD-10 Short Questions
Instructions to candidates: Using ICD-10 only, encode ALL the following statements. Morphology codes are required. Use the filler X in the 4th character space as appropriate. Put a line through any incorrect answers.
1. Mania as a manifestation of end stage renal disease.
ICD-10 ABC
2. Cryptococcal breast abscess in a patient who is HIV+.
ICD-10 ABC
3. NSTEMI of anterior territory.
ICD-10 ABC
4. Bilateral parietal bone fractures extending into the temporal bone on the right following a fall down some stairs.
ICD-10 ABC
5. Pleomorphic adenoma arising from the parotid tail.
ICD-10 ABC
6. Acute rectocolitis following endoscopy.
ICD-10 ABC
7. Left hemi-parkinsonism probably due to occupational manganese poisoning – former factory worker.
ICD-10 ABC
8. Oral allergy syndrome and lip angioedema after eating grapes.
ICD-10 ABC
9. Periprosthetic femoral fracture having tripped over kerb and fallen.
ICD-10 ABC
10. Carpal tunnel syndrome as a result of obesity in an elderly primigravida woman with gestational diabetes.
ICD-10 ABC
11. Retinochoroiditis as a result of congenital toxoplasmosis in a 14 month old baby.
ICD-10 ABC
12. Bronchial diverticulitis as a complication of bronchial asthma.
ICD-10 ABC
13. First and second degree burns of the oral cavity, pharynx and oesophagus having drunk ammonia from an unmarked clear plastic container at a friend’s house the morning after a party.
ICD-10 ABC
14. Acute bronchitis and tracheitis.
ICD-10 ABC
15. Myoglobinuria resulting from acute renal failure in a patient with type V glycogen storage disease.
ICD-10 ABC
/ Examiner’s use only
Examiner’s use only
Examiner’s use only
Examiner’s use only
Section 2
OPCS 4.5 Short Questions
Instructions to candidates: Using OPCS 4.5 only, encode ALL the following statements. Put a line through any incorrect answers.
1. Partial gastrectomy with jejunal transposition.
OPCS 4.5 ABC
2. Non-contrast MR angiogram of left and right lower limbs.
OPCS 4.5 ABC
3. Microvascular free myocutaneous flap from the left pectoralis major muscle, including thoracoacromial vessels to the right foot using standard microvascular techniques.
OPCS 4.5 ABC
4. Aorto-bi-iliac bypass for infrarenal abdominal aortic aneurysm.
OPCS 4.5 ABC
5. Fractionated epibulbar I-125 (Iodine-125) plaque radiotherapy of left bulbar conjunctival lesion.
OPCS 4.5 ABC
6. Posterior decompression laminectomy L3/S1 with a fusion a L4/L5.
OPCS 4.5 ABC
7. Reconstruction of a partially amputated external left ear with costal cartilage graft.
OPCS 4.5 ABC
8. Left limited lateral acromioplasty.
OPCS 4.5 ABC
9. Virtual gastroscopy using Multidetector CT.
OPCS 4.5 ABC
10. Solumedrol and Ara-C infusions given as part of ESHAP regimen, cycle 1, day 5 as a daycase.
OPCS 4.5 ABC
11. Direct intraperitoneal insemination of prepared spermataosoa at both tubal fimbria under real-time transvaginal sonographic guidance.
OPCS 4.5 ABC
12. Endoscopic injection of botulinum toxin at the gastroesophageal junction in a 4-quadrant fashion.
OPCS 4.5 ABC
13. Thoraco-endoscopic sympathetic block with clipping of the inter-ganglion trunk at the level of T2/T3.
OPCS 4.5 ABC
14. Argon laser removal of vascular skin lesions from face and right ear.
OPCS 4.5 ABC
15. Exjade(R) (deferasirox) in the treatment of chronic iron overload associated with blood transfusion.
OPCS 4.5 ABC
/ Examiner’s use only
Examiner’s use only
Examiner’s use only
Examiner’s use only
Section 3
ICD-10 and OPCS 4.5
Instructions to candidates: Using ICD-10 and OPCS 4.5, encode ALL the following statements. Morphology codes are required. Use the filler X in the 4th character space as appropriate. Put a line through any incorrect answers.
1. Immature senile cataract of both eyes. Phacoemulsification and implantation of foldable lens into right eye.
ICD-10 ABC / OPCS 4.5 ABC
2. CPAP for cardiogenic pulmonary oedema.
ICD-10 ABC / OPCS 4.5 ABC
3. Gastroscopy and biopsy of a peptic ulcer of the stomach penetrating into the liver in a chronic alcoholic.
ICD-10 ABC / OPCS 4.5 ABC4. Minimally invasive reduction and stabilisation of simultaneous bilateral fracture dislocations of both talar bodies using K-wires.
ICD-10 ABC / OPCS 4.5 ABC
5. Elective right orchidectomy of epidermoid cyst of the testicle.
ICD-10 ABC / OPCS 4.5 ABC
6. Adjustable gastric banding for the control of obesity and obesity related diabetes.
ICD-10 ABC / OPCS 4.5 ABC
7. Dense hemiplegia and a non-functional hand, one month post embolic middle artery stroke. Contrast CT brain shows a deep white matter lesion.
ICD-10 ABC / OPCS 4.5 ABC
8. Duodenal variceal bleeding treated with TIPS.
ICD-10 ABC / OPCS 4.5 ABC
9. Pseudoaneurysm of the common hepatic artery treated with endovascular stent-graft assisted retrograde gastroduodenal artery coil embolisation.
ICD-10 ABC / OPCS 4.5 ABC
10. Invasive pulmonary aspergillosis visualised and diagnosed by bronchoscopy with washings and bronchial biopsy.
ICD-10 ABC / OPCS 4.5 ABC
11. Child with non-accidental fracture dislocation at T12/L1 treated by closed manual reduction and hyperextension casting under sedation. Child services aware.
ICD-10 ABC / OPCS 4.5 ABC
12. Mohs micrographic surgery for a dermatofibrosarcoma protuberans of the vulva.
ICD-10 ABC / OPCS 4.5 ABC
13. Infliximab therapy for severe steroid-dependent asthma and COPD.
ICD-10 ABC / OPCS 4.5 ABC
14. Open reduction of radial head and ulna osteotomy with annular ligament reconstruction for congenital radial head dislocation.
ICD-10 ABC / OPCS 4.5 ABC
/ Examiner’s use only
Examiner’s use only
Examiner’s use only
End of Paper
Professional Association of Clinical Coders UK
Certificate Examination – Paper 1
November 2009 (V1.4 - Final)
Page 1 of 13