AHIMA AHIMA Clinical Documentation Improvement 2

Question 1

Which organization jointly developed the Official Guidelines for Coding and Reporting used with ICD-10-CM in the US?

Accepted Answer

CMS, NCHS, AHA, and AHIMA

Answer

AMA and AHA only

Answer

CMS and AMA only

Answer

WHO and CMS

Question 2

What is the purpose of a 'physician advisor' in a CDI program?

Accepted Answer

To review complex clinical documentation issues and support query escalations

Answer

To replace CDI specialists for all queries

Answer

To assign final MS-DRGs after discharge

Answer

To perform utilization management reviews only

Question 3

Which MS-DRG complication or comorbidity (CC) level carries the highest relative weight and reimbursement impact?

Accepted Answer

MCC (Major Complication or Comorbidity)

Answer

CC (Complication or Comorbidity)

Answer

No CC/MCC

Answer

Secondary CC

Question 4

What does 'specificity' mean in the context of ICD-10-CM coding for CDI purposes?

Accepted Answer

Selecting the most detailed code that accurately reflects the documented condition

Answer

Using the fewest possible codes

Answer

Coding only confirmed diagnoses

Answer

Assigning codes based on lab values

Question 5

In CDI, what is the 'case mix index' (CMI)?

Accepted Answer

The average relative weight of all MS-DRGs for a given period

Answer

The average length of stay for all patients

Answer

The ratio of surgical to medical cases

Answer

The percentage of cases with MCCs

Question 6

Which document serves as the foundation for CDI query standards in the US?

Accepted Answer

AHIMA/ACDIS CDI Query Practice Brief

Answer

CMS Conditions of Participation

Answer

Joint Commission Accreditation Standards

Answer

OIG Work Plan