Last Updated: Jul 29, 2026
No. of Questions: 140 Questions & Answers with Testing Engine
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| Section | Weight | Objectives |
|---|---|---|
| CDI Metrics & Statistics | 14–18% | - DRG comparison and denial analysis - Query response and volume tracking - Benchmarking and reporting - Quality audits and compliance monitoring |
| Research & Education | 11–15% | - Provider and staff education - Best practice research and implementation - Regulatory and guideline updates - Documentation improvement training materials |
| Clinical Coding Practice | 22–26% | - DRG, CPT, and HCPCS code assignment - Payer requirements and reimbursement models - Principal and secondary diagnosis identification - ICD-10-CM/PCS coding conventions and guidelines - Coding software and reference resources |
| Leadership | 17–22% | - Interdisciplinary collaboration - Provider engagement and communication - Policy and procedure creation - CDI program development and promotion |
| Compliance | 4–8% | - Legal and ethical documentation practices - AHIMA standards and regulatory requirements - Fraud and abuse prevention - Compliance monitoring and reporting |
| Record Review & Document Clarification | 24–28% | - Ethical provider query development - Identify documentation gaps and specificity issues - Query tracking and follow-up - POA, HAC, SOI, ROM clarification - Compliance with query standards |
1. Based on the flowchart below, at what point might the clinical documentation integrity practitioner (CDIP) enlist the help of the physician advisor/champion?
A) E - Physician agrees with query and documents in MR
B) C - Retrospective query opportunity identified
C) D - No retrospective query opportunity identified
D) H - Physician fails to respond tocquery
2. The third quarter target concurrent physician query response rate for each physician in a hospital gastroenterology department was 80%. Nine physicians met or exceeded this metric; however, two physicians had third quarter concurrent physician query response rates of 19% and 64%. What is the best course of action for the clinical documentation integrity (CDI) physician advisor/champion?
A) Schedule individual meetings with each low-performing physician
B) Schedule a group meeting with all physicians
C) Schedule a meeting with the chair of the gastroenterology department
D) Schedule individual meetings with each physician
3. 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) AHA Coding Clinic for ICD-10-CM/PCS
B) O ICD-10-CM/PCS Codebook
C) O AMA CPT Assistant
D) The Merck Manual
4. Tracking denials within the clinical documentation integrity program is important to
A) identify documentation improvement opportunities and educate as necessary
B) file a timely appeal if the medical center disagrees with the RAC findings
C) determine coding inaccuracies and educate as necessary
D) confirm reimbursement was appropriate
5. A clinical documentation integrity practitioner (CDIP) has been successful in getting physicians to respond to queries. However, when the CDIP poses a query to a specific doctor, there is no response at all. The CDIP has tried face-to-face conversations, calling, emails, texts, but still gets no response. What is the next step the CDIP should take?
A) Warn the other CDIPs that the doctor is a non-responder and to forego querying
B) Elevate the issue to the physician advisor/champion after the CDI supervisor has reviewed the case and deemed the query appropriate
C) Hold a meeting with the CDI director and the doctor to find out why the doctor is not responding to the queries
D) Report the doctor to the Vice President of Medical Affairs so the doctor understands the importance of clinical documentation
Solutions:
| Question # 1 Answer: D | Question # 2 Answer: A | Question # 3 Answer: C | Question # 4 Answer: A | Question # 5 Answer: B |
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