International classification of diseases (ICD) MCQs With Answer

Introduction: The International Classification of Diseases (ICD) is the global standard for disease coding, morbidity and mortality statistics, and health information exchange. For B. Pharm students, mastering ICD concepts—ICD-10 structure, ICD-11 innovations, chapter blocks (e.g., A00–B99, C00–D48), external cause codes, T and Y codes for poisonings and adverse drug reactions, and Z codes for encounters—is essential for pharmacovigilance, pharmacoepidemiology, clinical documentation, and drug safety reporting. Understanding coding rules, code selection, and how ICD supports research, prescribing audits, and adverse event signal detection strengthens clinical pharmacy practice and patient care. Now let’s test your knowledge with 30 MCQs on this topic.

Q1. What is the primary purpose of the International Classification of Diseases (ICD)?

• To provide standardized diagnostic codes for morbidity and mortality statistics
• To classify pharmaceutical ingredients by chemical structure
• To set global guidelines for clinical trials
• To regulate drug pricing internationally

Correct Answer: To provide standardized diagnostic codes for morbidity and mortality statistics

Q2. Which organization is responsible for maintaining and publishing the ICD?

• Food and Agriculture Organization (FAO)
• World Health Organization (WHO)
• International Pharmaceutical Federation (FIP)
• Centers for Disease Control and Prevention (CDC)

Correct Answer: World Health Organization (WHO)

Q3. Which ICD revision was officially released by WHO in 2019 and introduced digital and postcoordination features?

• ICD-8
• ICD-9
• ICD-10
• ICD-11

Correct Answer: ICD-11

Q4. What is the basic code format convention of ICD-10?

• Numeric codes of 3 digits only
• Letter followed by two digits, with an optional decimal and up to two additional characters
• Two letters followed by three digits and a suffix
• Alphanumeric code of fixed length 6 with no decimal

Correct Answer: Letter followed by two digits, with an optional decimal and up to two additional characters

Q5. Which feature distinguishes ICD-11 from ICD-10 for more granular clinical detail?

• Removal of chapter structure
• Use of stem codes combined with extension (postcoordination) codes
• Only numeric codes are allowed
• Exclusively paper-based coding guidelines

Correct Answer: Use of stem codes combined with extension (postcoordination) codes

Q6. Which ICD-10 chapter covers neoplasms?

• Chapter I (A00–B99)
• Chapter II (C00–D48)
• Chapter V (F00–F99)
• Chapter XI (K00–K93)

Correct Answer: Chapter II (C00–D48)

Q7. Which code block in ICD-10 is used for external causes of morbidity and mortality?

• G00–G99
• V01–Y98
• M00–M99
• O00–O99

Correct Answer: V01–Y98

Q8. Which ICD-10 code range identifies poisoning by drugs, medicaments and biological substances?

• T36–T50
• F10–F19
• Z00–Z99
• J00–J99

Correct Answer: T36–T50

Q9. In ICD-10, which codes are specifically used to indicate adverse effects related to therapeutic use of drugs?

• X60–X84
• Y40–Y59
• E10–E14
• S00–T98

Correct Answer: Y40–Y59

Q10. Which ICD-10 block is used for factors influencing health status and contact with health services (healthcare encounters, screenings, vaccination status)?

• A00–B99
• C00–D48
• Z00–Z99
• L00–L99

Correct Answer: Z00–Z99

Q11. How is ICD commonly used in pharmacoepidemiology and pharmacovigilance?

• To classify drug chemical structures for synthesis
• To identify disease prevalence only, unrelated to drugs
• To code diagnoses and events enabling detection of drug-related hospitalizations and adverse drug reactions
• To replace spontaneous adverse event reporting systems entirely

Correct Answer: To code diagnoses and events enabling detection of drug-related hospitalizations and adverse drug reactions

Q12. What is the definition of ‘underlying cause of death’ used in ICD mortality coding?

• The immediate mechanism that directly caused death
• The physician who certified the death
• The disease or injury that initiated the train of events leading directly to death
• The place where death occurred

Correct Answer: The disease or injury that initiated the train of events leading directly to death

Q13. In ICD coding instructions, what does the note ‘code first’ typically mean?

• Code the most recent condition first
• Always code external causes before underlying disease
• Code the underlying condition before additional manifestations
• Skip sequencing and code any condition arbitrarily

Correct Answer: Code the underlying condition before additional manifestations

Q14. Which ICD chapter contains mental and behavioural disorders?

• Chapter I (A00–B99)
• Chapter V (F00–F99)
• Chapter IX (I00–I99)
• Chapter XIV (N00–N99)

Correct Answer: Chapter V (F00–F99)

Q15. How many main chapters are there in ICD-10?

• 10
• 22
• 35
• 50

Correct Answer: 22

Q16. Which ICD-10 chapter is designated for diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism?

• Chapter III (D50–D89)
• Chapter VII (H00–H59)
• Chapter XIII (N00–N99)
• Chapter XIX (S00–T98)

Correct Answer: Chapter III (D50–D89)

Q17. What is the practical role of ‘U’ codes in ICD-10?

• Codes for common outpatient procedures
• Reserved for special purposes and provisional assignment of new diseases
• Codes exclusively for dental conditions
• Deprecated codes with no current use

Correct Answer: Reserved for special purposes and provisional assignment of new diseases

Q18. In ICD-11, what does ‘postcoordination’ enable coders to do?

• Use only single, fixed-length codes for every condition
• Combine a primary (stem) code with one or more extension codes to add details such as severity, laterality, or medication involvement
• Randomly assign multiple codes without clinical basis
• Automatically translate codes into drug names

Correct Answer: Combine a primary (stem) code with one or more extension codes to add details such as severity, laterality, or medication involvement

Q19. Which ICD-10 chapter includes infectious and parasitic diseases?

• A00–B99
• G00–G99
• K00–K93
• R00–R99

Correct Answer: A00–B99

Q20. What is the chapter for endocrine, nutritional and metabolic diseases in ICD-10?

• Chapter IV (E00–E90)
• Chapter VIII (H60–H95)
• Chapter X (K00–K93)
• Chapter XVI (O00–O99)

Correct Answer: Chapter IV (E00–E90)

Q21. Which statement correctly distinguishes ICD from the ATC classification?

• ICD classifies drugs by mechanism; ATC classifies diseases by organ system
• ICD classifies diseases and health conditions; ATC classifies drugs and medicines by therapeutic use and chemical characteristics
• Both ICD and ATC are identical systems for diseases
• ATC replaces ICD for mortality statistics

Correct Answer: ICD classifies diseases and health conditions; ATC classifies drugs and medicines by therapeutic use and chemical characteristics

Q22. For coding a drug-related death in ICD-10, which combination of codes would typically be used?

• Use only Z codes
• Immediate cause coded with T36–T50 and contributing adverse effect coded with Y40–Y59
• Only external cause codes V00–V99 are used
• Code with F00–F99 for psychiatric evaluation

Correct Answer: Immediate cause coded with T36–T50 and contributing adverse effect coded with Y40–Y59

Q23. Which ICD-10 block would you examine to find codes for poisoning by antibiotics?

• T36–T50 (poisoning by drugs, medicaments and biological substances)
• J00–J99 (respiratory diseases)
• M00–M99 (musculoskeletal diseases)
• Z00–Z99 (factors influencing health status)

Correct Answer: T36–T50 (poisoning by drugs, medicaments and biological substances)

Q24. When coding sequelae (late effects) in ICD-10, what is the recommended approach?

• Code only the late effect without reference to the cause
• Code the condition that produced the sequela first, followed by the sequela code
• Sequelae are not coded in ICD-10
• Use external cause codes only

Correct Answer: Code the condition that produced the sequela first, followed by the sequela code

Q25. How does accurate ICD coding benefit clinical pharmacists in hospital settings?

• It increases medication manufacturing speed
• It helps in drug utilization review, adverse event detection, and clinical audit
• It replaces the need for clinical notes entirely
• It is only useful for billing and has no clinical value

Correct Answer: It helps in drug utilization review, adverse event detection, and clinical audit

Q26. Which code block contains codes for signs, symptoms and abnormal clinical and laboratory findings not elsewhere classified?

• R00–R99
• E00–E90
M00–M99
• A00–B99

Correct Answer: R00–R99

Q27. Who in a healthcare facility should ideally be trained in ICD coding to ensure quality data for pharmacy practice?

• Only administrative staff with no clinical background
• Clinical coders supported by healthcare professionals, including pharmacists and physicians
• Patients themselves
• External auditors only once a year

Correct Answer: Clinical coders supported by healthcare professionals, including pharmacists and physicians

Q28. What role do Z codes (Z00–Z99) play in pharmacotherapy documentation?

• They indicate drug chemical structure
• They document encounters for care, vaccination, medication management, and therapy-related status
• They list only surgical procedures
• They are obsolete and not used in practice

Correct Answer: They document encounters for care, vaccination, medication management, and therapy-related status

Q29. Which ICD chapter would you consult for respiratory system diseases such as pneumonia?

• J00–J99
• K00–K93
• N00–N99
• G00–G99

Correct Answer: J00–J99

Q30. In hospital coding, what is meant by the ‘primary diagnosis’ for an inpatient stay?

• The diagnosis discovered at discharge but not treated
• The main condition treated or investigated during the hospital stay
• The rarest condition listed in the chart
• The first diagnosis recorded in the patient’s lifetime

Correct Answer: The main condition treated or investigated during the hospital stay

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