CDIP Physician Query Process 5

Question 1

A CDI specialist notices that a patient was treated for heart failure but the physician documented only 'dyspnea.' What is the most appropriate action?

Accepted Answer

Send a query presenting heart failure and other clinically supported options for physician clarification

Answer

When clinical indicators suggest a specific condition not documented by the physician, a compliant query presenting supported options is the correct step.

Question 2

Which of the following best describes the 'agree/disagree' query format?

Accepted Answer

A query where the CDI specialist states a diagnosis and asks if the physician agrees or disagrees

Answer

The agree/disagree format presents one diagnosis and asks the physician to confirm or deny it, and is generally considered acceptable when strong clinical support exists.

Question 3

Which professional organization, along with AHIMA, co-authored the 'Guidelines for Achieving a Compliant Query Practice'?

Accepted Answer

ACDIS

Answer

AHIMA and ACDIS jointly published the industry-standard guidelines that define compliant physician query practices.

Question 4

When a query results in a diagnosis that changes the DRG to a higher-weighted group, this is referred to as:

Accepted Answer

A DRG shift or upgrade that is compliant when clinically supported

Answer

A DRG shift to a higher-weighted group is appropriate and compliant when the new diagnosis is fully supported by clinical documentation.

Question 5

Which of the following is a key metric used to evaluate the effectiveness of a CDI program's query process?

Accepted Answer

Physician query agreement rate

Answer

Physician query agreement rate measures how often physicians confirm the queried diagnosis, reflecting both query quality and CDI-physician alignment.

(CDIP) Certified Documentation Improvement Practitioner Practice Test

(CDIP) Certified Documentation Improvement Practitioner Practice Test

CDIP Physician Query Process 5