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AHIMA CDIP Exam Syllabus Topics:
| Section | Weight | Objectives |
|---|---|---|
| Topic 1: Compliance | 4–8% | - Compliance monitoring and reporting - Fraud and abuse prevention - AHIMA standards and regulatory requirements - Legal and ethical documentation practices |
| Topic 2: Leadership | 17–22% | - Policy and procedure creation - CDI program development and promotion - Interdisciplinary collaboration - Provider engagement and communication |
| Topic 3: CDI Metrics & Statistics | 14–18% | - Quality audits and compliance monitoring - DRG comparison and denial analysis - Benchmarking and reporting - Query response and volume tracking |
| Topic 4: Record Review & Document Clarification | 24–28% | - POA, HAC, SOI, ROM clarification - Ethical provider query development - Identify documentation gaps and specificity issues - Query tracking and follow-up - Compliance with query standards |
| Topic 5: Research & Education | 11–15% | - Provider and staff education - Best practice research and implementation - Regulatory and guideline updates - Documentation improvement training materials |
| Topic 6: Clinical Coding Practice | 22–26% | - Payer requirements and reimbursement models - ICD-10-CM/PCS coding conventions and guidelines - Principal and secondary diagnosis identification - Coding software and reference resources - DRG, CPT, and HCPCS code assignment |
AHIMA Certified Documentation Integrity Practitioner Sample Questions:
1. Which of the following committees should determine the chain of comnfand that will be used to manage physicians who are either unresponsive or uncooperative with the clinical documentation integrity (CDI) program?
A) Oversight
B) Compliance
C) Communications
D) Operations
2. A query should be generated when the documentation is
A) conflicting
B) complete
C) legible
D) consistent
3. A clinical documentation integrity practitioner (CDIP) in an acute care hospital was asked to create new query templates for ICD-10 based on AHIMA and ACDIS guidelines. What should the multiple-choice query format include?
A) Impact on reimbursement
B) Clinically unsupported diagnosis
C) Clinically insignificant options
D) Clinically significant options
4. The facility has received a clinical validation denial for sepsis. The denial states sepsis is not a clinically valid diagnosis because it does not meet Sepsis-3 criteria. The facility has a policy stating it uses Sepsis-2 criteria.
What is the BEST next step?
A) Appeal the denial because all payors must use the hospital's sepsis criteria when reviewing their claims.
B) Remove sepsis from all claims where the diagnosis is not supported by sepsis 3 criteria.
C) Query physicians when Sepsis-3 criteria is not met so they can provide additional documentation to support the diagnosis.
D) Have the contracting department work with payors to obtain agreement on how sepsis will be clinically validated.
5. The clinical documentation integrity (CDI) manager has noted a query response rate of 60%. The CDI practitioner reports that physicians often respond verbally to the query. What can be done to improve this rate?
A) Have CDI manager teaming with coding supervisor to monitor physician responses
B) Require physicians to document responses in charts
C) Allow physician to respond via e-mail
D) Permit CDI practitioners to document physician responses in the charts
Solutions:
| Question # 1 Answer: A | Question # 2 Answer: A | Question # 3 Answer: D | Question # 4 Answer: D | Question # 5 Answer: B |
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