QUESTION: 1

An increase in claim denials has prompted a clinical documentation integrity (CDI) manager to engage the CDI physician advisor/champion in an effort to avoid future denials. How does this strategy impact the goal?

Clinicians will not require documentation integrity education.
Physicians can manage the documentation integrity process.
Physicians will learn documentation integrity practices from peers.
The CDI manager will exclusively provide education.

Answer(s): C

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QUESTION: 2

A clinical documentation integrity practitioner (CDIP) generates a concurrent query and continues to follow retrospectively; however, the coder releases the bill before the query is answered. The CDIP wonders if it is appropriate to re-bill the account if the physician answers the query after the bill has dropped. Which policy should the hospital follow to avoid a compliance risk?

A rebilling is permissible when queries are answered after the initial bill.
A post bill query rarely occurs as a result of an audit of other internal monitor.
A post bill query is not appropriate when an error is found after an audit.
A second bill should not be submitted when the first bill was incomplete.

Answer(s): A

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QUESTION: 3

A patient is admitted for pneumonia with a WBC of 20,000, respiratory rate 20, heart rate 85, and oral temperature 99.0°. On day 2, sputum cultures reveal positive results for pseudomonas bacteria. The most appropriate action is to:

code pneumonia, unspecified
query the provider to see if pseudomonas sepsis is supported by the health record
code pseudomonas pneumonia
query the provider to document the etiology of pneumonia

Answer(s): D

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