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AHIMA Certified Documentation Integrity Practitioner Sample Questions:

1. Which member of the clinical documentation integrity (CDI) team can help provide peer-to-peer level of education on the importance of accurate documentation and query responses?

A) CDI practitioner
B) Chief Financial Officer
C) CDI manager
D) Physician advisor/champion

2. A key physician approaches the director of the coding department about the new emphasis associated with clinical documentation integrity (CDI). The physician does not support the program and believes the initiative will encourage inappropriate billing.
How should the director respond to the concerns?

A) Inform the physician that changes must be made
B) Develop an administrative panel to oversee CDI process
C) Refer the physician to the finance department to discuss required billing changes
D) Involve the physician advisor/champion in addressing the medical staff's concerns

3. A pressure ulcer stage III is documented in the progress note. The clinical documentation integrity practitioner (CDIP) has queried the attending regarding the present on admission status of the pressure ulcer but has not received a response in an appropriate time frame. What should the CDIP do next?

A) Escalate issue to medical staff leadership
B) Escalate issue to hospital administration
C) Query surgical consultant
D) Query wound care nurse

4. A clinical documentation integrity practitioner (CDIP) is reviewing an outpatient surgical chart. The patient underwent a laparoscopic appendectomy for acute gangrenous appendicitis. Which coding reference should be used for coding advice on correct assignment of the procedure code for proper ambulatory payment classification (APC) reimbursement?

A) O ICD-10-CM/PCS Codebook
B) The Merck Manual
C) O AMA CPT Assistant
D) AHA Coding Clinic for ICD-10-CM/PCS

5. Which physician would best benefit from additional education for unanswered queries?

A) Dr. D
B) Dr. B
C) Dr. A
D) Dr. C

Solutions: