AHIMA CDIP : Certified Documentation Integrity Practitioner

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AHIMA Certified Documentation Integrity Practitioner Sample Questions:

1. A patient was admitted for high fever and pain in umbilical region. During the second day of the hospital stay, the patient stood up to use the restroom and fell on the floor, resulting in a broken chin bone. A physician noted the fall on the second day in progress note. Which further clarification should be done regarding present on admission (POA) indicator of fall?

A) No query is needed
B) Bring this case up in weekly Health Information Management meetings for further action
C) Take the case to physician advisor/champion to discuss further action
D) Query physician for POA

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

3. When benchmarking with outside organizations, the clinical documentation integrity practitioner (CDIP) must determine if the organization is benchmarking with which of the following criteria?

A) Hospitals that are its peers
B) Hospital within its state
C) Hospital within its region
D) Hospital within its county

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

5. A patient is admitted due to pneumonia. On day 1, a sputum culture is positive for psuedomonas bacteria. If the physician is queried and agrees that the patient has pseudomonas pneumonia, this specificity would

A) not meet medical necessity
B) not increase relative weight
C) increase relative weight
D) meet medical necessity

Solutions: