CDIP Toolkit questions with correct answers

recent drivers of CDI (p2) CORRECT ANSWER - MS-DRGs 2007 to reflect SOI/ROM - POA indicators 2008 - Medicare Advantage/Part C (capitated, HCC) - some payers moving to APR DRGs - compliance reviews: RAC, Zone Program Integrity Contractors, Medicaid Integ Contractors purpose of CDI program (p2) CORRECT ANSWER to initiate concurrent and, as appropriate, retrospective reviews of health records for conflicting, incomplete, or nonspecific provider documentation. goal of CDI reviews (p2) CORRECT ANSWER to identify clinical indicators to ensure that all diagnoses and procedures are supported by ICD-9-CM codes. key CDI stakeholders (p3) CORRECT ANSWER • HIM and coding departments • Case management and utilization review • Medical staff and physician leadership • Executive leadership • Patient financial services or billing • Finance and revenue cycle • Quality and risk management • Nursing • Compliance and ethics some examples of CDI goals (p4) CORRECT ANSWER • Obtain clinical documentation that captures the patient severity of illness and risk of mortality • Identify and clarify missing, conflicting, or nonspecific physician documentation related to diagnoses and procedures