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CERTIFIED DOCUMENTATION INTEGRITY PRACTITIONER (CDIP) FINAL EXAM QUESTIONS AND ANSWERS 2024
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CERTIFIED DOCUMENTATION INTEGRITY PRACTITIONER (CDIP) FINAL EXAM QUESTIONS AND ANSWERS 2024
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CERTIFIED DOCUMENTATION INTEGRITYPRACTITIONER (CDIP) FINAL EXAM
The attending physician noted the patient had a CVA with hemorrhage. For
complete ICD-10 code assignment, documentation integrity, and quality
reporting, it may be beneficial to determine
a.Location or source of hemorrhage
b.Laterality
c.Document any associated diagnoses or conditions
d.All of the above - ANSWERS-d When a CVA is due to a hemorrhage
documentation requirements include Due to Hemorrhage-Location or source of
hemorrhage, Laterality, Document any associated diagnoses/conditions (AHIMA
2015a, 28).
Ms. Smith is a 75-year-old SNF patient with tonsillar neoplasm undergoing
radiation treatment. The patient presented and was admitted with fever,
elevated WBCs, raspy cough, and consolidation noted on chest x-ray. The
attending physician documented pneumonia with subsequent query. The CDS
most likely queries for
a.The type of pneumonia
b.The type of neoplasm
c.Another element of the documentation
d.The query was not warranted - ANSWERS-a The patient was undergoing
radiation which is consistent with malignancy and query would be needed to
,specify the type of pneumonia as Aspiration-Ventilator-associated-Radiation-
induced-Other (specify) (AHIMA 2015a, 32).
It is important to have a process in place for denials. This is called a:
a.RAC process
b.Disciplinary action plan
c.Denial management process
d.Fraud protection - ANSWERS-c All organizations should have a process to
monitor and track denials; denials management process (Hess 2015, 242)
Billed DRGDRG Wt.Revised DRGDRG Wt.Total Agree with denialTotal
Denials682RENAL FAILURE W MCC1.5194683RENAL FAILURE W
CC0.95121010637DIABETES W MCC1.3944638DIABETES W CC0.8261520
What is the denial rate for DRG 682?
a.0 percent
b.25 percent
c.50 percent
d.100 percent - ANSWERS-d The denial rate for DRG 682 is 100%: (10/10)* 100 =
100%
Billed DRGDRG Wt.Revised DRGDRG Wt.Total Agree with denialTotal
Denials682RENAL FAILURE W MCC1.5194683RENAL FAILURE W
CC0.95121010637DIABETES W MCC1.3944638DIABETES W CC0.8261520
,What is the denial rate for DRG 637?
a.0 percent
b.25 percent
c.50 percent
d.100 percent - ANSWERS-b The denial impact of DRG 637 is 25%: (5/20)*100 =
25%
Billed DRGDRG Wt.Revised DRGDRG Wt.Total Agree with denialTotal
Denials682RENAL FAILURE W MCC1.5194683RENAL FAILURE W
CC0.95121010637DIABETES W MCC1.3944638DIABETES W CC0.8261520
What is the financial impact for DRG 682?:
a.$11,414.40
b.$18,232.80
c.$6,818.40
d.$5,230.00 - ANSWERS-c The financial impact for DRG 682 is
$6818.40:($1200*1.5194*10=18232.80) - ($1200*0.9512*10=1141440)=
$6818.40
Using the admission criteria provided, determine if the following patient meets
the severity of illness and intensity of service criteria for admission.
Severity of IllnessIntensity of ServicePersistent feverInpatient-approved
surgery/procedure within 24 hours of admissionActive bleedingIntravenous
, medications or fluid replacementWound dehiscenceVital signs every 2 hours or
more often
Sue presents with vaginal bleeding. An ultrasound showed a missed abortion, so
she is being admitted to the outpatient surgery suite for a D&C.
a.The patient does not meet both severity of illness and intensity of service
criteria.
b.The patient meets both severity of illness and intensity of service criteria.
c.The patient meets intensity of service criteria but not severity of illness.
d.The patient meets severity of illness criteria but not intensity of service. -
ANSWERS-d The patient meets the severity of illness with the vaginal bleeding but
does not meet intensity of service because the surgery is not being performed as
an inpatient. She would not meet the admission criteria provided (Shaw and
Elliott 2012, 113, 120).
SURGICAL HIERARCHY
MDC 03 Diseases & Disorders of the Ear, Nose, Mouth & Throat
129-130 Major Head and Neck Procedures
131-132 Cranial/Facial Procedures
133-134 Other Ear, Nose, Mouth and Throat Procedures
135-136 Sinus and Mastoid Procedures
137-138 Mouth Procedures
Based on the surgical hierarchy above, a patient that has which procedure in the
example is lowest in the hierarchy
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