CDIP CDI Metrics and Statistics 2 — Questions and Answers
Question 1: Which metric best reflects the effectiveness of a CDI specialist in capturing additional diagnoses during a hospitalization?
- Average length of stay
- Impact rate
- CC/MCC capture rate (Correct answer)
- Physician query rate
Correct answer: CC/MCC capture rate
CC/MCC capture rate measures how often CDI specialists successfully identify and document complication or comorbidity diagnoses that affect MS-DRG assignment.
Question 2: A CDI department tracks the number of queries that result in a documentation change versus total queries issued. This is called the:
- Query volume rate
- Agreement rate (Correct answer)
- Query response rate
- Specificity rate
Correct answer: Agreement rate
The agreement rate (or compliance rate) measures the percentage of physician queries that result in an actual documentation change.
Question 3: When calculating Case Mix Index (CMI), which data source is most authoritative for benchmarking a hospital's performance?
- Internal billing records only
- CMS Medicare Provider Analysis and Review (MedPAR) data (Correct answer)
- EHR discharge summaries
- State insurance commission reports
Correct answer: CMS Medicare Provider Analysis and Review (MedPAR) data
CMS MedPAR data provides standardized national benchmarks for CMI comparison across similar hospitals.
Question 4: A hospital's CDI team wants to measure how often records are reviewed before the patient is discharged. Which metric does this describe?
- Concurrent review rate (Correct answer)
- Retrospective query rate
- Discharge completion rate
- Pre-bill review rate
Correct answer: Concurrent review rate
Concurrent review rate tracks the percentage of eligible inpatient records reviewed while the patient is still admitted.
Question 5: Which of the following would MOST likely indicate a CDI program is under-performing in capturing present on admission (POA) indicators?
- High CMI relative to peers
- Elevated HAC penalty rates (Correct answer)
- High CC/MCC capture rate
- Low query volume
Correct answer: Elevated HAC penalty rates
Elevated Hospital-Acquired Condition (HAC) penalty rates often reflect inaccurate or missing POA indicators, which CDI is responsible for improving.
Question 6: A CDI specialist calculates that 42 out of 200 queried cases resulted in a DRG change. What is the DRG change rate?
- 21% (Correct answer)
- 42%
- 4.2%
- 0.21%
Correct answer: 21%
DRG change rate = (42 ÷ 200) × 100 = 21%, reflecting how often queries led to a different DRG assignment.
Question 7: Which statistical concept helps CDI programs determine whether a CMI improvement is due to true documentation improvement versus patient population changes?
- Standard deviation
- Case mix normalization (risk adjustment) (Correct answer)
- Regression to the mean
- Coefficient of variation
Correct answer: Case mix normalization (risk adjustment)
Case mix normalization or risk adjustment isolates documentation improvement from shifts in patient severity or demographics.
CDIP CDI Metrics and Statistics 2
Which metric best reflects the effectiveness of a CDI specialist in capturing additional diagnoses during a hospitalization?