Physician Query Process 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 Physician Query Process flashcards as text
A query is sent to clarify whether a patient's respiratory failure is acute, chronic, or acute-on-chronic. This is an example of what type of query opportunity?
Answer: Specificity clarification
Asking the physician to specify the acuity of a condition (acute vs. chronic vs. acute-on-chronic) is a specificity clarification query.
Which of the following clinical scenarios would most likely trigger a query for 'sepsis'?
Answer: Patient has tachycardia, fever, elevated WBC, and is on broad-spectrum IV antibiotics for pneumonia
Systemic signs such as tachycardia, fever, leukocytosis, and IV antibiotic use for a documented infection suggest sepsis, warranting a query.
When querying for a complication of care, the CDI specialist must ensure that:
Answer: Clinical documentation supports a potential relationship between a procedure and the complication
Queries for complications of care must be supported by clinical indicators suggesting a procedural relationship before being sent.
A physician responds to a query by writing a late entry addendum to the medical record. This response is considered:
Answer: Acceptable as long as the addendum is dated, timed, and authenticated per facility policy
Physician addenda are a valid and acceptable way to respond to queries as long as they follow proper documentation standards including date, time, and signature.
What does the term 'query rate' measure in a CDI program?
Answer: The number of queries sent divided by the number of cases reviewed
Query rate is calculated as the number of queries sent relative to cases reviewed and is used to monitor CDI program activity.
Which of the following scenarios represents an appropriate use of a post-discharge query?
Answer: Querying to clarify clinical indicators documented during the stay that were not addressed before discharge
Post-discharge queries are appropriate when valid clinical indicators from the admission are unaddressed and clarification is needed for accurate coding.
In the context of physician queries, what does 'response rate' indicate?
Answer: The proportion of sent queries that receive a physician response
Response rate tracks what percentage of issued queries actually receive a physician reply, reflecting physician engagement with the CDI process.