AHIMA CDIP : Certified Documentation Integrity Practitioner

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AHIMA CDIP Exam Syllabus Topics:

AHIMA Certified Documentation Integrity Practitioner Sample Questions:

1. 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

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

2. A query should be generated when the documentation is

A) complete
B) conflicting
C) legible
D) consistent

3. Which of the following is nonessential to facilitate code capture when educating clinical staff on documentation practices associated with diabetes mellitus?

A) Type
B) Cause
C) Age
D) Manifestation

4. The most beneficial step to identify post-discharge query opportunities that affect severity of illness, risk of mortality and case weight is to

A) determine if only the treatment is documented and there is no diagnosis documented
B) identify normal diagnostic test results that may indicate a possible addition of a secondary diagnosis
C) look for documented conditions that have well supported accompanying clinical criteria
D) watch for reportable conditions or conditions that are unambiguous or otherwise complete

5. The provider was queried because the patient met clinical criteria for acute hypoxic respiratory failure. The response to the query was different than what was expected by the clinical documentation integrity practitioner (CDIP). What should the CDIP do?

A) Implement the department's escalation process
B) Revise the query and send it back to the provider
C) Have a different CDIP query the provider
D) Record the query response as disagreed

Solutions: