Certified Documentation Integrity Practitioner (CDIP)

Question 1

In the APR-DRG grouping system, 'Severity of Illness' (SOI) is best defined as:

The probability that a patient will die during the hospitalization The total number of secondary diagnoses present at discharge The extent of physiologic decompensation or organ system loss of function The financial weight assigned to the base APR-DRG

Correct Answer:

The extent of physiologic decompensation or organ system loss of function

Question 2

APR-DRG Severity of Illness and Risk of Mortality subclasses are each rated on which scale?

0 to 3 (0=none through 3=major) 1 to 4 (1=minor, 2=moderate, 3=major, 4=extreme) 1 to 5 (1=minimal through 5=extreme) A to D (A=minor through D=extreme)

Correct Answer:

1 to 4 (1=minor, 2=moderate, 3=major, 4=extreme)

Question 3

Which payer type most commonly uses APR-DRGs as a basis for hospital inpatient reimbursement?

Medicare fee-for-service (Traditional Medicare) TRICARE/military health plans Medicaid programs and many commercial managed care health plans Indian Health Service (IHS) facilities

Correct Answer:

Medicaid programs and many commercial managed care health plans

Question 4

A patient admitted with sepsis develops acute kidney injury during the stay, which the hospitalist documents but does not explicitly link to the sepsis. Clarifying this causal relationship through a physician query would most likely result in:

No impact on APR-DRG assignment since sepsis already carries high severity A reduction in the SOI subclass by adding a competing diagnosis An impact only on outpatient reimbursement, not inpatient APR-DRG grouping An increase in both SOI and ROM subclasses, more accurately reflecting the patient's clinical complexity

Correct Answer:

An increase in both SOI and ROM subclasses, more accurately reflecting the patient's clinical complexity

Question 5

A post-discharge query would affect a patient's APR-DRG SOI and ROM subclasses but would NOT change the MS-DRG assignment. This query is still clinically valuable primarily because:

It can retroactively increase Medicare reimbursement after the claim is paid It improves accuracy of quality reporting, outcomes benchmarking, and Medicaid or commercial payer reimbursement CMS regulations require all post-discharge queries within 60 days of discharge It eliminates the requirement for present-on-admission (POA) indicator review

Correct Answer:

It improves accuracy of quality reporting, outcomes benchmarking, and Medicaid or commercial payer reimbursement

Question 1

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About this Exam

Prepare with the Certified Documentation Integrity Practitioner (CDIP) practice quiz. This question bank includes 140 questions covering query, patient, physician, specialist, and documentation. Use it to review important concepts, identify knowledge gaps, and build confidence for the related exam, course, or assessment.

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Certified Documentation Integrity Practitioner (CDIP)

This practice set contains 140 questions from the matching question bank and focuses on query, patient, physician, specialist, and documentation. Work through each question carefully, review the provided solutions, and revisit topics that need more study before your next attempt.

This is an independent study resource intended for practice and review; it is not an official examination or an endorsement by any organization named in the title.

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About this Exam

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Certified Documentation Integrity Practitioner (CDIP)

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