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AHIMA CDIP Exam Syllabus Topics:

AHIMA Certified Documentation Integrity Practitioner Sample Questions:

1. A hospital noticed a 30% denial rate in Medicare claims due to lack of clinical documentation, placing the hospital at risk of multiple Medicare violations. What step should the clinical documentation integrity (CDI) manager take to help avoid future Medicare violations?
Collaborate with physician advisor/champion and revenue cycle manager
Instruct the billing department to write off claims with insufficient documentation

A) Assign pre-billing claim review duties to physicians
B) Prevent submission of claims for improper documentation

2. The physician advisor/champion needs to provide ongoing education regarding coding and reimbursement regulations to the

A) Health Information Management coding staff
B) organization senior administration staff
C) clinical documentation integrity staff
D) organization's medical and surgical staff

3. When a change in departmental workflow is necessary, the first step is to

A) re-engineer the process
B) set realistic timelines
C) define the gaps and solutions
D) assess the current workflow

4. Creating policies and procedures for the query process will help eliminate

A) risk
B) confusion
C) indecision
D) duplication

5. A hospital administrator wants to initiate a clinical documentation integrity (CDI) program and has developed a steering committee to identify performance metrics. The CDI manager expects to use a case mix index as one of the metrics. Which other metric will need to be measured?

A) Assessment of CC/MCC capture rates
B) Comparison of risk of mortality with diagnostic related group capture rates
C) Assessment of APR-DRGs with capture of CC or MCC
D) Comparison of severity of illness with the CC capture rates

Solutions: