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AHIMA Certified Documentation Integrity Practitioner Sample Questions:

1. When queries are part of the health record, which of the following physician privilege could be suspended if the provider receives too many deficiencies due to incomplete records for failure to respond to queries?

A) Credentialing
B) Consulting
C) Admitting
D) Surgical

2. A hospital clinical documentation integrity (CDI) director suspects physicians are over-using electronic copy and paste in patient records, a practice that increases the risk of fraudulent insurance billings. A documentation integrity project may be needed. What is the first step the CDI director should take?

A) Bring together a team of physicians and informatics specialists
B) Recommend the physicians to be involved in the project
C) Alert senior leadership to the record documentation problem
D) Gather data on the incidence of inaccurate record documentation

3. A pressure ulcer stage III is documented in the progress note. The clinical documentation integrity practitioner (CDIP) has queried the attending regarding the present on admission status of the pressure ulcer but has not received a response in an appropriate time frame. What should the CDIP do next?

A) Query surgical consultant
B) Escalate issue to hospital administration
C) Query wound care nurse
D) Escalate issue to medical staff leadership

4. When are concurrent queries initiated?

A) After the health record has been coded
B) After discharge of the patient
C) While the patient is hospitalized
D) Before patient is admitted

5. Which of the following is an example of a hospital-acquired condition when not present on admission?

A) Iatrogenic pneumothorax with lung biopsy
B) Iatrogenic pneumothorax with venous catheterization
C) Pressure ulcer stage III
D) Pressure ulcer stage II

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