CDI Metrics and Statistics Flashcards
7 cards from real CDIP practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 CDI Metrics and Statistics flashcards as text
Which metric best reflects the effectiveness of a CDI specialist in capturing additional diagnoses during a hospitalization?
Answer: CC/MCC capture rate
CC/MCC capture rate measures how often CDI specialists successfully identify and document complication or comorbidity diagnoses that affect MS-DRG assignment.
A CDI department tracks the number of queries that result in a documentation change versus total queries issued. This is called the:
Answer: Agreement rate
The agreement rate (or compliance rate) measures the percentage of physician queries that result in an actual documentation change.
When calculating Case Mix Index (CMI), which data source is most authoritative for benchmarking a hospital's performance?
Answer: CMS Medicare Provider Analysis and Review (MedPAR) data
CMS MedPAR data provides standardized national benchmarks for CMI comparison across similar hospitals.
A hospital's CDI team wants to measure how often records are reviewed before the patient is discharged. Which metric does this describe?
Answer: Concurrent review rate
Concurrent review rate tracks the percentage of eligible inpatient records reviewed while the patient is still admitted.
Which of the following would MOST likely indicate a CDI program is under-performing in capturing present on admission (POA) indicators?
Answer: Elevated HAC penalty rates
Elevated Hospital-Acquired Condition (HAC) penalty rates often reflect inaccurate or missing POA indicators, which CDI is responsible for improving.
A CDI specialist calculates that 42 out of 200 queried cases resulted in a DRG change. What is the DRG change rate?
Answer: 21%
DRG change rate = (42 ÷ 200) × 100 = 21%, reflecting how often queries led to a different DRG assignment.
Which statistical concept helps CDI programs determine whether a CMI improvement is due to true documentation improvement versus patient population changes?
Answer: Case mix normalization (risk adjustment)
Case mix normalization or risk adjustment isolates documentation improvement from shifts in patient severity or demographics.