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

The Official Guidelines are a cooperative effort of four organizations: CMS, NCHS, AHA, and AHIMA.

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

A physician advisor supports CDI programs by reviewing clinically complex cases, educating physicians, and resolving disputes between CDI specialists and attending physicians.

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

MCCs (Major Complications or Comorbidities) carry the highest relative weight in MS-DRG grouping, reflecting greater resource utilization.

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

ICD-10-CM requires coding to the highest level of specificity, using the most detailed code available that accurately represents the condition.

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 case mix index is the average relative weight of MS-DRGs for a hospital's patient population, reflecting the complexity and resource intensity of cases treated.

(AHIMA) American Health Information Management Association Practice Test

(AHIMA) American Health Information Management Association Practice Test

AHIMA AHIMA Clinical Documentation Improvement 2