ICPC Quiz
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On this page you can test your ICPC coding knowledge by taking an interactive quiz. It will immediately show whether your answer is right or wrong when you press the “check” button. There is also a short explanation after each question.
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Question 1 of 20
1. Question
Mr. Elbers (66 years) visits the clinic for the third time in a short period because of his abdominal complaints that still bother him. You have started a few weeks ago the episode “local abdominal pain”.
Patient starts the conversation with the following sentence:
P: I still have pain in my upper abdomen.
Question: What is on the basis of this information, the RFE? (Multiple answers possible)
Correct
The RFE is D06 (other localized abdominal pain).
D01 (generalized abdominal pain / cramps): Patient calls the pain ‘upper abdominal pain’, so it is local pain and not generalized.
D31 (partial physical examination): This code is used you if the patient asks for physical examinations.
D63 (follow-up contact is not specified): This code is almost never given.
Incorrect
The RFE is D06 (other localized abdominal pain).
D01 (generalized abdominal pain / cramps): Patient calls the pain ‘upper abdominal pain’, so it is local pain and not generalized.
D31 (partial physical examination): This code is used you if the patient asks for physical examinations.
D63 (follow-up contact is not specified): This code is almost never given.
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Question 2 of 20
2. Question
You propose to have an electrocardiogram and you refer the patient to the nurse to make an appointment for this.
Question: What is the resulting intervention? (Multiple answers possible)?
Correct
The correct answer is D45 or K45 (information / advice). The chapter letter does not matter much in this case.
Your advice is to make an EKG. The patient makes an appointment with the nurse for the EKG. The assistant will then encode the EKG. As practitioner, you should not also code the EKG, because otherwise you code two times the same electrocardiogram. The same applies, for example, advice for spirometry, audiometry, lavage ed.
Incorrect
The correct answer is D45 or K45 (information / advice). The chapter letter does not matter much in this case.
Your advice is to make an EKG. The patient makes an appointment with the nurse for the EKG. The assistant will then encode the EKG. As practitioner, you should not also code the EKG, because otherwise you code two times the same electrocardiogram. The same applies, for example, advice for spirometry, audiometry, lavage ed.
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Question 3 of 20
3. Question
Three days later, the patient visits the assistant for making an EKG. They then make an appointment with the doctor to discuss the outcome of this EKG.
What are the intervention? (Multiple answers possible)
Correct
The correct answer is K42 (electrical tracing K – chapter) and K45 or D45 .
39 code (physical function test): The EKG is the only function test with a separate code (42). All other functional assessment (audiometry, pulmonary function, etc.) encode using the 39 rubric.
D42 (electrical tracing D – section): You cannot make an electrical tracing of the abdomen (D – section). An EKG is always K42. Even though the EKG made because abdominal discomfort (D – section), still you encode K42.
45 Code: If you also advises the patient to discuss the outcome with the GP then you code K45 or D45. The chapter letter does not matter much.
Incorrect
The correct answer is K42 (electrical tracing K – chapter) and K45 or D45 .
39 code (physical function test): The EKG is the only function test with a separate code (42). All other functional assessment (audiometry, pulmonary function, etc.) encode using the 39 rubric.
D42 (electrical tracing D – section): You cannot make an electrical tracing of the abdomen (D – section). An EKG is always K42. Even though the EKG made because abdominal discomfort (D – section), still you encode K42.
45 Code: If you also advises the patient to discuss the outcome with the GP then you code K45 or D45. The chapter letter does not matter much.
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Question 4 of 20
4. Question
Sander (6 years old) is visiting you with his mother. The conversation between mother (M) and the (family) doctor (A) is as follows:
M: “I ‘m afraid Sander has eczema ‘
A: “Why do you think that?”
M: “He has a rash under his ear. It exists now a few days and it seems to extend.
A: “Have you yourself already done something?”
M: “I have smeared an ointment, but nothing seemed to help ‘Question: What is the RFE? (Multiple answers possible)
Correct
The RFE is S87 (atopic dermatitis) or S88 (contact dermatitis). Mother mentionse eczema, but not the cause of the eczema. If she clearly indicates that she suspects that the eczema is caused by a contact allergy or because it occurs in the family then you can consciously choose S88 (contact dermatitis) or S87 (atopic dermatitis), respectively.
S06 (local rash): Mother calls only local rash when the doctor asks. This is not an RFE.
S07 (generalized rash): This code is used as a mother herself had indicated that he would have rashes all over the body.Incorrect
The RFE is S87 (atopic dermatitis) or S88 (contact dermatitis). Mother mentionse eczema, but not the cause of the eczema. If she clearly indicates that she suspects that the eczema is caused by a contact allergy or because it occurs in the family then you can consciously choose S88 (contact dermatitis) or S87 (atopic dermatitis), respectively.
S06 (local rash): Mother calls only local rash when the doctor asks. This is not an RFE.
S07 (generalized rash): This code is used as a mother herself had indicated that he would have rashes all over the body. -
Question 5 of 20
5. Question
After physical examination you suggest the diagnosis of impetigo. You will explain this condition and recommends good hygiene. Besides you prescribe an antibiotic cream.
Question: What is/are the resulting intervention? (Multiple answers possible)
Correct
The correct answer is both S45 (information/advice) and S50 (prescription).
S49 (other preventive procedure): The 49 code is used as the resulting intervention in cardiovascular risk intervention in the Netherlands (K49). Another reason for using the 49 code as resulting intervention is currently not there.
Incorrect
The correct answer is both S45 (information/advice) and S50 (prescription).
S49 (other preventive procedure): The 49 code is used as the resulting intervention in cardiovascular risk intervention in the Netherlands (K49). Another reason for using the 49 code as resulting intervention is currently not there.
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Question 6 of 20
6. Question
Finally, the doctor decides to talk about Sander’s obesity.
What is RFE? (Multiple answers possible)
Correct
The correct answer is T64 (episode/contact initiative counselor), because the doctor decides to bring up the topic. Obesity was not the reason for encounter.
T82 (obesity) and T83 (overweight) are coded as RFE if the patient himself starts the consultation with obesity or overweight. Because the patient will often say “I suffer from obesity ‘instead of’ I suffer from my obesity” will you encode in most cases T83 (overweight).
Incorrect
The correct answer is T64 (episode/contact initiative counselor), because the doctor decides to bring up the topic. Obesity was not the reason for encounter.
T82 (obesity) and T83 (overweight) are coded as RFE if the patient himself starts the consultation with obesity or overweight. Because the patient will often say “I suffer from obesity ‘instead of’ I suffer from my obesity” will you encode in most cases T83 (overweight).
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Question 7 of 20
7. Question
After a conversation with Sander and his mother you decide to refer Sander to the physiotherapist.
What is the resulting intervention? (Multiple answers possible)
Correct
The correct answer is T66 (referral to other primary care provider)
T57 (physiotherapy/rehabilitation) is almost never used, only when you do the therapy by yourself.
T67 (referral to specialist/hospital): Physical therapy is one of the providers in the first line, not the second line (specialist care/hospital/clinic)
T68 (another referral NEC) is almost never used.Incorrect
The correct answer is T66 (referral to other primary care provider)
T57 (physiotherapy/rehabilitation) is almost never used, only when you do the therapy by yourself.
T67 (referral to specialist/hospital): Physical therapy is one of the providers in the first line, not the second line (specialist care/hospital/clinic)
T68 (another referral NEC) is almost never used. -
Question 8 of 20
8. Question
Mr. V comes to your clinic with a red rash on his right arm. He has this now since 2 weeks and he answers your questions: it itches and gets bigger. It does not hurt.
He do not use medication.
After physical examination you decide to ask the dermatologist to look at the rash using teledermatology.Question: What is the RFE?
Correct
the RFE is S06 (local rash).
S07 (generalized rash) is used if the rash was all over the body.
S02 (itching): The itchiness as complaint/symptom is given after questioning, so this is not an RFE.
S08 (change in skin color): patient says he has a rash, not that his skin is red. The RFE is not S08Incorrect
the RFE is S06 (local rash).
S07 (generalized rash) is used if the rash was all over the body.
S02 (itching): The itchiness as complaint/symptom is given after questioning, so this is not an RFE.
S08 (change in skin color): patient says he has a rash, not that his skin is red. The RFE is not S08 -
Question 9 of 20
9. Question
Mr. V comes to your clinic with a red rash on his right arm. He has this now since 2 weeks and he answers your questions: it itches and gets bigger. It does not hurt. He do not use medication.
After physical examination you decide to ask the dermatologist to look at the rash using teledermatology.Question: What is the resulting intervention?
Correct
S47 (consulting specialist). In teledermatology, but also in telenephrology or telecardiology, you do not refer the patient to a specialist, but you start a (digital) consultation with the specialist. You as the GP keeps the responsibility for the patient. Thence S47.
S45 (advice): Use when you give the patient advice, such as “wait still one week and if it do not disappear come back.”
S67 (referral specialist): used when you actually refers the patient to a consultation with the specialist.
S68 (referral NEC) is almost never used.Incorrect
S47 (consulting specialist). In teledermatology, but also in telenephrology or telecardiology, you do not refer the patient to a specialist, but you start a (digital) consultation with the specialist. You as the GP keeps the responsibility for the patient. Thence S47.
S45 (advice): Use when you give the patient advice, such as “wait still one week and if it do not disappear come back.”
S67 (referral specialist): used when you actually refers the patient to a consultation with the specialist.
S68 (referral NEC) is almost never used. -
Question 10 of 20
10. Question
Jonas (4 years) comes along with his mother at the clinic. Mother tells the GP that Jonas has put a bead in his ear this morning.
Question: What is the RFE based on this information? (Multiple answers possible)
Correct
Reply
The correct answer is H76 (foreign body in the ear).H01 (earache): the mother of Jonas has not mentioned ear pain as a complaint.
H13 (clogged ear feeling): the mother of Jonas has not mentioned as a complaint “clogged ear feeling”.
H65 (encounter/problem initiated by other than patient/provider): when children visit the clinic at the initiative of one of the parents, then you do not encode 65. It is logical that children of this age visit the clinic on the initiative of an adult.
Incorrect
Reply
The correct answer is H76 (foreign body in the ear).H01 (earache): the mother of Jonas has not mentioned ear pain as a complaint.
H13 (clogged ear feeling): the mother of Jonas has not mentioned as a complaint “clogged ear feeling”.
H65 (encounter/problem initiated by other than patient/provider): when children visit the clinic at the initiative of one of the parents, then you do not encode 65. It is logical that children of this age visit the clinic on the initiative of an adult.
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Question 11 of 20
11. Question
Homecare (a nurse) is calling you about Mrs. Divers. She accidentally ingested her hypertension medication of today and tomorrow. The nurse asks what to do?
Question: What is the RFE? (Multiple answers possible)
Correct
The correct answer is K65 (episode/contact third initiative): This episode starts by the nurse. K45 (information/advice) and K46 (consultation within the first line) are interventions. The 47 and 46 are not to be used for reasons for encounter.
K31 (medical examination/health evaluation partial): This code you use when the patient visit you to measure his/her blood pressure
Incorrect
The correct answer is K65 (episode/contact third initiative): This episode starts by the nurse. K45 (information/advice) and K46 (consultation within the first line) are interventions. The 47 and 46 are not to be used for reasons for encounter.
K31 (medical examination/health evaluation partial): This code you use when the patient visit you to measure his/her blood pressure
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Question 12 of 20
12. Question
Next comes Emma (2 years) with her father at the clinic. Emma has since 3 days fever and is coughing a lot. During physical examination, you can see a clear runny nose, do not hear abnormal lung sounds and her ears show no signs of inflammation.
Question: Which code for the diagnosis?
Correct
The correct answer is R74 (acute upper respiratory infection)
A03 (fever): the agreement is to encode as precisely as possible. The fever comes with Emma probably by a cold, also because of the cough and runny nose. Hence, you do not encode “fever” as a diagnosis, but R74.
R05 (cough): Same as A03 (fever)
R07 (sneezing / nasal congestion): Same as A03 (fever)
R97 (allergic rhinitis), there seems to be no question of an allergic rhinitis as a cause of her symptoms.
Incorrect
The correct answer is R74 (acute upper respiratory infection)
A03 (fever): the agreement is to encode as precisely as possible. The fever comes with Emma probably by a cold, also because of the cough and runny nose. Hence, you do not encode “fever” as a diagnosis, but R74.
R05 (cough): Same as A03 (fever)
R07 (sneezing / nasal congestion): Same as A03 (fever)
R97 (allergic rhinitis), there seems to be no question of an allergic rhinitis as a cause of her symptoms.
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Question 13 of 20
13. Question
Stefan (3 years) has fever for 4 days. After history taking and physical examination you find no cause for this fever.
Which code for the diagnosis?
Correct
The correct answer is A03 (fever).
A77 (another viral disease NEC): You do not know whether the fever is caused by a virus disease. During history and physical examination, you did not find evidence for a virus infection.
R74 (acute upper respiratory infection): You do not know whether the fever is caused by an upper respiratory infection, by history and physical examination you did not find evidence for R74.
Incorrect
The correct answer is A03 (fever).
A77 (another viral disease NEC): You do not know whether the fever is caused by a virus disease. During history and physical examination, you did not find evidence for a virus infection.
R74 (acute upper respiratory infection): You do not know whether the fever is caused by an upper respiratory infection, by history and physical examination you did not find evidence for R74.
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Question 14 of 20
14. Question
This patient is known for a long time having a depression. You recently started a tricyclic antidepressant. Now the patient visit you because he suffers from dry mouth. The patient feels a lot better since the start of the prescription (after 6 weeks already). You explain that dry mouth is a side effect of the antidepressant. In consultation with the patient you decide NOT to stop the antidepressant because of this adverse event .
What you encode as a diagnosis?
Correct
The correct answer is P76 (depressive disorder): The advice is to put this encounter in the existing episode ‘Depression’.
D20 (symptoms/complaints mouth/tongue/lips): patient complains indeed of a dry mouth, but because this is a side effect of the medication that you give for depression, you may put this to the episode ‘Depression’ (P76).
A85 (drug side effect): we decided to use the code A85 as diagnosis when the patient stops taking the medication because of the side effects. As this patient decides NOT to stop, you do not encode A85. So we use the code A85 as diagnosis when the side effect is clinical relevant!
A87 (complication medical treatment): a side effect of a medication is excluded from A87.
Incorrect
The correct answer is P76 (depressive disorder): The advice is to put this encounter in the existing episode ‘Depression’.
D20 (symptoms/complaints mouth/tongue/lips): patient complains indeed of a dry mouth, but because this is a side effect of the medication that you give for depression, you may put this to the episode ‘Depression’ (P76).
A85 (drug side effect): we decided to use the code A85 as diagnosis when the patient stops taking the medication because of the side effects. As this patient decides NOT to stop, you do not encode A85. So we use the code A85 as diagnosis when the side effect is clinical relevant!
A87 (complication medical treatment): a side effect of a medication is excluded from A87.
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Question 15 of 20
15. Question
The next patient asks for her vitamin B12 injection.
Question: What is the RFE? (Multiple answers possible)
Correct
The correct answer is -50 (medication/prescription/injection).
-49 (Other preventive procedures): The 49 code is used as the resulting intervention in cardio vascular risk management (CVRM in the Netherlands) (K49). Another reason for using the 49 code is currently not there.
-55 (Local injection/infiltration): This code is used when you give an injection to achieve a local effect, for instance in the case of a bursitis. In case of a vitamin B12 injection, the effect is not local, so you encode -50.
Incorrect
The correct answer is -50 (medication/prescription/injection).
-49 (Other preventive procedures): The 49 code is used as the resulting intervention in cardio vascular risk management (CVRM in the Netherlands) (K49). Another reason for using the 49 code is currently not there.
-55 (Local injection/infiltration): This code is used when you give an injection to achieve a local effect, for instance in the case of a bursitis. In case of a vitamin B12 injection, the effect is not local, so you encode -50.
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Question 16 of 20
16. Question
The mother of Jonas calls up and says the following: “Jonas is crying so hard lately. I think he hears bade. Can this be tested? ”
What is the RFE? (Multiple answers are possible)
Correct
The correct answer is H02 (symptoms/complaints hearing) and H39 (physical function test).
H13 (clogged ear feeling): Mother did not mention the fact that Jonah may have a clogged sensation in his ear.
H86 (deafness): a suspected hearing loss is not enough information to immediately encode H86 (deafness).
Incorrect
The correct answer is H02 (symptoms/complaints hearing) and H39 (physical function test).
H13 (clogged ear feeling): Mother did not mention the fact that Jonah may have a clogged sensation in his ear.
H86 (deafness): a suspected hearing loss is not enough information to immediately encode H86 (deafness).
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Question 17 of 20
17. Question
The 18-year-old Melissa calls. She says: “I have had unprotected sex two days ago. I’m so scared that I’m pregnant. ”
What is the RFE? (Multiple answers are possible)
Correct
The correct answer is W02 (fear to be pregnant).
W01 (question of pregnancy): Melissa calls because of a fear of pregnancy (W02). This can, in this case encoded more specific than W01 (question of pregnancy).
W31 (partial physical examination): She does not ask for a physical examination, so you should not use this rubric.
W45 (health education/advice): She does not ask explicitly for advice, so you should not use this rubric.
Incorrect
The correct answer is W02 (fear to be pregnant).
W01 (question of pregnancy): Melissa calls because of a fear of pregnancy (W02). This can, in this case encoded more specific than W01 (question of pregnancy).
W31 (partial physical examination): She does not ask for a physical examination, so you should not use this rubric.
W45 (health education/advice): She does not ask explicitly for advice, so you should not use this rubric.
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Question 18 of 20
18. Question
Ms. Claassen calls the practice to tell that she is pregnant. You advise her to contact the midwife.
Question: What is the resulting intervention? (Multiple answers are possible)
Correct
The correct answer is W45 (information/advice). You give advice to contact the midwife. It is too much for this simple advice to use the referral code W66 (referral other primary care provider). When you write a letter you can use W66.
W67 (referral to specialist/hospital): This rubric when you refer patient to the hospital
W68 (other referral NEC): we do not use this code
Incorrect
The correct answer is W45 (information/advice). You give advice to contact the midwife. It is too much for this simple advice to use the referral code W66 (referral other primary care provider). When you write a letter you can use W66.
W67 (referral to specialist/hospital): This rubric when you refer patient to the hospital
W68 (other referral NEC): we do not use this code
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Question 19 of 20
19. Question
Months later you get a message from the midwife that Ms. Claassen gave birth to a healthy son. You use the ICPC code W90 (uncomplicated childbirth Live Births)
Question: Do you link this ICPC code to the pregnancy episode or do you have to start a separate episode W90?
Correct
The correct answer is “I’ll start a separate episode W90 (uncomplicated labour/delivery livebirth), in addition to the already existing pregnancy episode.
If you link to the episode pregnancy W78, then you will lose the pregnancy episode and you cannot properly count how many pregnant women there were in the past year, for example. Hence, we create a separate episode, pregnancy and childbirth as a separate episode.
Another example: you make if necessary a separate episode ‘miscarriage’ on the next episode of pregnancy.Incorrect
The correct answer is “I’ll start a separate episode W90 (uncomplicated labour/delivery livebirth), in addition to the already existing pregnancy episode.
If you link to the episode pregnancy W78, then you will lose the pregnancy episode and you cannot properly count how many pregnant women there were in the past year, for example. Hence, we create a separate episode, pregnancy and childbirth as a separate episode.
Another example: you make if necessary a separate episode ‘miscarriage’ on the next episode of pregnancy. -
Question 20 of 20
20. Question
Bart (18 years), comes to the practice. He explains that he has just fallen and has problems with his ankle.
What is the RFE? (Multiple answers are possible)Correct
The correct answer is L16 (ankle signs/symptoms) and L29 (other symptoms/complaints musculoskeletal). Bart says he has problems with his ankle. This is RFE L16. He indicates that he has fallen. This is RFE L29.
L20 (symptoms/complaints joint nao): This rubric you only use if you cannot be more specific with using the rubrics L01 to L17 or if there are many joints where the patient suffers from.
L77 (ankle sprain/distortion): Patient does not indicate that he has a distortion, he just says that he has problems with his ankle. You do not encode L77 as RFE.
Incorrect
The correct answer is L16 (ankle signs/symptoms) and L29 (other symptoms/complaints musculoskeletal). Bart says he has problems with his ankle. This is RFE L16. He indicates that he has fallen. This is RFE L29.
L20 (symptoms/complaints joint nao): This rubric you only use if you cannot be more specific with using the rubrics L01 to L17 or if there are many joints where the patient suffers from.
L77 (ankle sprain/distortion): Patient does not indicate that he has a distortion, he just says that he has problems with his ankle. You do not encode L77 as RFE.