CDIP CDI Metrics and Statistics 3

Question 1

A hospital notices its observed-to-expected (O/E) mortality ratio is greater than 1.0. What does this indicate?

Accepted Answer

Higher mortality than predicted by the risk model

Answer

An O/E mortality ratio above 1.0 means actual deaths exceed what the risk model predicted, potentially indicating documentation gaps or quality issues.

Question 2

Which of the following CDI metrics is MOST directly tied to MS-DRG reimbursement optimization?

Accepted Answer

Relative weight per discharge

Answer

Relative weight per discharge directly reflects the resource intensity assigned by MS-DRGs and is the primary driver of Medicare reimbursement.

Question 3

A CDI team is benchmarking its physician query response rate. The industry benchmark is typically considered to be:

Accepted Answer

Above 70%

Answer

A physician query response rate above 70% is commonly cited as a performance benchmark, though best-in-class programs aim for 90%+.

Question 4

Which metric measures the average number of diagnoses documented per inpatient discharge?

Accepted Answer

Code density

Answer

Code density (or diagnosis density) tracks the average number of coded diagnoses per discharge, often used to compare documentation thoroughness.

Question 5

A CDI program reports a 'missed opportunity rate.' What does this metric typically represent?

Accepted Answer

Cases where no query was sent despite documentation gaps

Answer

Missed opportunity rate identifies cases where a CDI review was performed but no query was issued despite identifiable documentation gaps.

(CDIP) Certified Documentation Improvement Practitioner Practice Test

(CDIP) Certified Documentation Improvement Practitioner Practice Test

CDIP CDI Metrics and Statistics 3