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AHIMA CDIP Exam Syllabus Topics:
| Section | Weight | Objectives |
|---|---|---|
| Topic 1: Clinical Coding Practice | 22–26% | - DRG, CPT, and HCPCS code assignment - Payer requirements and reimbursement models - Principal and secondary diagnosis identification - ICD-10-CM/PCS coding conventions and guidelines - Coding software and reference resources |
| Topic 2: Compliance | 4–8% | - Fraud and abuse prevention - Compliance monitoring and reporting - Legal and ethical documentation practices - AHIMA standards and regulatory requirements |
| Topic 3: Record Review & Document Clarification | 24–28% | - Compliance with query standards - Query tracking and follow-up - POA, HAC, SOI, ROM clarification - Ethical provider query development - Identify documentation gaps and specificity issues |
| Topic 4: CDI Metrics & Statistics | 14–18% | - Quality audits and compliance monitoring - DRG comparison and denial analysis - Benchmarking and reporting - Query response and volume tracking |
| Topic 5: Leadership | 17–22% | - Policy and procedure creation - CDI program development and promotion - Provider engagement and communication - Interdisciplinary collaboration |
| Topic 6: Research & Education | 11–15% | - Provider and staff education - Regulatory and guideline updates - Documentation improvement training materials - Best practice research and implementation |
AHIMA Certified Documentation Integrity Practitioner Sample Questions:
1. Which of the following clinical documentation integrity (CDI) dashboard metrics is frequently used to help evaluate the credibility of CDI practitioner queries and the success of the CDI program?
A) CDI query rate
B) Provider agreement rate
C) Provider response rate
D) CDI agreement rate
2. A clinical documentation integrity (CDI) program that is compliant with regulations from the facility's payors results in
A) less risk from audits
B) meeting external benchmarks
C) higher overall program cost
D) need for more CDI staff
3. When a change in departmental workflow is necessary, the first step is to
A) set realistic timelines
B) define the gaps and solutions
C) re-engineer the process
D) assess the current workflow
4. The third quarter target concurrent physician query response rate for each physician in a hospital gastroenterology department was 80%. Nine physicians met or exceeded this metric; however, two physicians had third quarter concurrent physician query response rates of 19% and 64%. What is the best course of action for the clinical documentation integrity (CDI) physician advisor/champion?
A) Schedule individual meetings with each low-performing physician
B) Schedule individual meetings with each physician
C) Schedule a meeting with the chair of the gastroenterology department
D) Schedule a group meeting with all physicians
5. 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) Hospital within its state
B) Hospital within its county
C) Hospitals that are its peers
D) Hospital within its region
Solutions:
| Question # 1 Answer: B | Question # 2 Answer: A | Question # 3 Answer: D | Question # 4 Answer: A | Question # 5 Answer: C |
