AHIMA Clinical Documentation Improvement Flashcards
6 cards from real AHIMA practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 6 AHIMA Clinical Documentation Improvement flashcards as text
Which organization jointly developed the Official Guidelines for Coding and Reporting used with ICD-10-CM in the US?
Answer: CMS, NCHS, AHA, and AHIMA
The Official Guidelines are a cooperative effort of four organizations: CMS, NCHS, AHA, and AHIMA.
What is the purpose of a 'physician advisor' in a CDI program?
Answer: To review complex clinical documentation issues and support query escalations
A physician advisor supports CDI programs by reviewing clinically complex cases, educating physicians, and resolving disputes between CDI specialists and attending physicians.
Which MS-DRG complication or comorbidity (CC) level carries the highest relative weight and reimbursement impact?
Answer: MCC (Major Complication or Comorbidity)
MCCs (Major Complications or Comorbidities) carry the highest relative weight in MS-DRG grouping, reflecting greater resource utilization.
What does 'specificity' mean in the context of ICD-10-CM coding for CDI purposes?
Answer: Selecting the most detailed code that accurately reflects the documented condition
ICD-10-CM requires coding to the highest level of specificity, using the most detailed code available that accurately represents the condition.
In CDI, what is the 'case mix index' (CMI)?
Answer: The average relative weight of all MS-DRGs for a given period
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.
Which document serves as the foundation for CDI query standards in the US?
Answer: AHIMA/ACDIS CDI Query Practice Brief
The AHIMA/ACDIS CDI Query Practice Brief provides industry-standard guidelines for compliant, ethical, and clinically appropriate physician queries.