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AHIMA Certified Documentation Integrity Practitioner Sample Questions:

1. Patient is admitted with oliguria, pulmonary edema, and dehydration. Labs are remarkable for an elevated creatinine of 2.4, with a baseline of 1.1. Patient was hydrated for 48 hours with drop in creatinine. What would the appropriate action be?

A) Code acute renal failure since symptoms are there and documented
B) Query the physician to see if acute renal failure with tubular necrosis is supported
C) No query is needed because the patient was dehydrated
D) Query the physician to see if acute renal failure is clinically supported

2. Which of the following individuals should the clinical documentation integrity (CDI) manager consult when developing query policy and procedures?

A) Chief Financial Officer
B) Compliance Officer
C) Chief Medical Officer
D) CDI practitioner

3. Reviewing and analyzing physician query content on a regular basis

A) helps to calculate query response rate
B) facilitates physician data collection
C) aids in discussion between physician and reviewer
D) assists in identifying gaps in skills and knowledge

4. Educating physicians on severity of illness and risk of mortality is best accomplished by utilizing

A) physician report cards
B) case studies
C) the DRG Expert
D) the case mix index

5. What type of query may NOT be used in circumstances where only clinical indicators of a condition are present, and the condition/diagnosis has not been documented in the health record?

A) Verbal
B) Yes/No
C) Multiple-choice
D) Open-ended

Solutions: